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Jo EA, Ahn S, Mo H, Jung IM, Kim HK, Ko H, Han A, Min S, Ha J, Min SK. A 20-Year Analysis of Ruptured Abdominal Aortic Aneurysm Outcomes and Associated Factors in Korea. Ann Vasc Surg 2024; 102:152-159. [PMID: 38307230 DOI: 10.1016/j.avsg.2023.10.033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Revised: 10/09/2023] [Accepted: 10/30/2023] [Indexed: 02/04/2024]
Abstract
BACKGROUND Unlike western countries, which have reported distinct decreases in incidence of ruptured abdominal aortic aneurysm (rAAA) over the last few decades, epidemiologic studies in Korea have not shown significant changes in incidence or mortality of rAAA. The purpose of this study was to analyze the changes in rAAA treatment outcomes and various associated risk factors over the past 2 decades. METHODS A 20-year retrospective multicenter review for rAAA cases from the period of January 2000 to December 2020 was undertaken. Preoperative, intraoperative and postoperative clinical data were extracted for patients diagnosed with rAAA. For analysis, outcomes from the early era, defined as patients treated between January 1, 2000, and December 31, 2010, were compared with outcomes from the late era, defined as patients treated between January 1, 2011, and December 31, 2020. RESULTS The total in-hospital mortality was 34.1% in the early era compared to 44.8% in the late era. Patients in the late era were older than those in the early era (75.2 ± 10.3 years vs. 70.3 ± 8.9 years; P = 0.009). Treatment with rAAA endovascular aneurysm repair increased from 2.3% in early to 13.8% in late era (P = 0.031). In the early era, more patients were operated by experienced surgeons than the late era (78.1% vs. 45.9%; P = 0.002). The emergency room to operating room time did not show improvement over the 20 years. CONCLUSIONS The results indicate that mortality rate of rAAA in Korea has not changed over the last 2 decades. The study suggests the need for national preventive strategies, improved systemic coordination, and potential centralization of vascular services to enhance survival rates for rAAA.
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Affiliation(s)
- Eun-Ah Jo
- Department of Surgery, Seoul National University College of Medicine, Seoul, Korea; Department of Surgery, Seoul National University Bundang Hospital, Seongnam-si, Korea
| | - Sanghyun Ahn
- Department of Surgery, Seoul National University College of Medicine, Seoul, Korea.
| | - Hyejin Mo
- Department of Surgery, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul, Korea
| | - In-Mok Jung
- Department of Surgery, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul, Korea
| | - Hyo Kee Kim
- Department of Surgery, Korea University Guro Hospital, Seoul, Korea
| | - Hyunmin Ko
- Department of Surgery, Kyung Hee University Medical Center, Seoul, Korea
| | - Ahram Han
- Department of Surgery, Seoul National University College of Medicine, Seoul, Korea
| | - Sangil Min
- Department of Surgery, Seoul National University College of Medicine, Seoul, Korea
| | - Jongwon Ha
- Department of Surgery, Seoul National University College of Medicine, Seoul, Korea
| | - Seung-Kee Min
- Department of Surgery, Seoul National University College of Medicine, Seoul, Korea
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Kim JM, Kang SJ, Hong SH, Chung H, Shin JS, Min BH, Kim HJ, Ha J, Park CG. Long-term control of diabetes by tofacitinib-based immunosuppressive regimen after allo islet transplantation in diabetic rhesus monkeys that rejected previously transplanted porcine islets. Xenotransplantation 2024; 31:e12850. [PMID: 38501729 DOI: 10.1111/xen.12850] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2023] [Revised: 12/15/2023] [Accepted: 02/10/2024] [Indexed: 03/20/2024]
Abstract
Porcine islet xenotransplantation has been highlighted as an alternative to allo islet transplantation. Despite the remarkable progress that has been made in porcine-islet pre-clinical studies in nonhuman primates, immunological tolerance to porcine islets has not been achieved to date. Therefore, allo islet transplantation could be required after the failure of porcine islet xenotransplantation. Here, we report the long-term control of diabetes by allogeneic pancreatic islet transplantation in diabetic rhesus monkeys that rejected previously transplanted porcine islets. Four diabetic male rhesus monkeys received the porcine islets and then allo islets (5700-19 000 IEQ/kg) were re-transplanted for a short or long period after the first xeno islet rejection. The recipient monkeys were treated with an immunosuppressive regimen consisting of ATG, humira, and anakinra for induction, and sirolimus and tofacitinib for maintenance therapy. The graft survival days of allo islets in these monkeys were >440, 395, >273, and 127, respectively, similar to that in allo islet transplanted cynomolgus monkeys that received the same immunosuppressive regimen without xeno sensitization. Taken together, it is likely that prior islet xenotransplantation does not affect the survival of subsequent allo islets under clinically applicable immunosuppressants.
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Affiliation(s)
- Jong-Min Kim
- Xenotransplantation Research Center, Seoul National University, College of Medicine, Seoul, South Korea
- Department of Microbiology and Immunology, Seoul National University, College of Medicine, Seoul, South Korea
- Transplantation Research Institute, Seoul National University Medical Research Center, Seoul National University, College of Medicine, Seoul, South Korea
- Cancer Research Institute, Seoul National University, College of Medicine, Seoul, South Korea
- Department of Animal Health, Cheongju University College of Health and Medical Sciences, Cheongju, South Korea
| | - Seong-Jun Kang
- Xenotransplantation Research Center, Seoul National University, College of Medicine, Seoul, South Korea
- Department of Microbiology and Immunology, Seoul National University, College of Medicine, Seoul, South Korea
- Department of Biomedical Sciences, Seoul National University, College of Medicine, Seoul, South Korea
| | - So-Hee Hong
- Department of Microbiology, College of Medicine, Ewha Womans University, Seoul, Republic of Korea
| | - Hyunwoo Chung
- Xenotransplantation Research Center, Seoul National University, College of Medicine, Seoul, South Korea
- Department of Microbiology and Immunology, Seoul National University, College of Medicine, Seoul, South Korea
- Department of Biomedical Sciences, Seoul National University, College of Medicine, Seoul, South Korea
| | - Jun-Seop Shin
- Xenotransplantation Research Center, Seoul National University, College of Medicine, Seoul, South Korea
- Transplantation Research Institute, Seoul National University Medical Research Center, Seoul National University, College of Medicine, Seoul, South Korea
- Cancer Research Institute, Seoul National University, College of Medicine, Seoul, South Korea
| | - Byoung-Hoon Min
- Xenotransplantation Research Center, Seoul National University, College of Medicine, Seoul, South Korea
- Transplantation Research Institute, Seoul National University Medical Research Center, Seoul National University, College of Medicine, Seoul, South Korea
- Cancer Research Institute, Seoul National University, College of Medicine, Seoul, South Korea
| | - Hyun Je Kim
- Xenotransplantation Research Center, Seoul National University, College of Medicine, Seoul, South Korea
- Department of Microbiology and Immunology, Seoul National University, College of Medicine, Seoul, South Korea
- Cancer Research Institute, Seoul National University, College of Medicine, Seoul, South Korea
- Department of Biomedical Sciences, Seoul National University, College of Medicine, Seoul, South Korea
| | - Jongwon Ha
- Department of Surgery, Seoul National University College of Medicine, Seoul, South Korea
| | - Chung-Gyu Park
- Xenotransplantation Research Center, Seoul National University, College of Medicine, Seoul, South Korea
- Department of Microbiology and Immunology, Seoul National University, College of Medicine, Seoul, South Korea
- Transplantation Research Institute, Seoul National University Medical Research Center, Seoul National University, College of Medicine, Seoul, South Korea
- Cancer Research Institute, Seoul National University, College of Medicine, Seoul, South Korea
- Department of Biomedical Sciences, Seoul National University, College of Medicine, Seoul, South Korea
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Han A, Min S, Jo EA, Lee H, Kim YC, Han SS, Kang HG, Ahn YH, Oh I, Song EY, Ha J. Association Between Low Anti-spike Antibody Levels After the Third Dose of SARS-CoV-2 Vaccination and Hospitalization due to Symptomatic Breakthrough Infection in Kidney Transplant Recipients. Ann Lab Med 2024; 44:64-73. [PMID: 37665287 PMCID: PMC10485855 DOI: 10.3343/alm.2024.44.1.64] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Revised: 05/11/2023] [Accepted: 07/26/2023] [Indexed: 09/05/2023] Open
Abstract
Background Whether anti-severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) antibody levels post-third coronavirus disease (COVID-19) vaccination correlate with worse outcomes due to breakthrough infection is unclear. We evaluated the association between anti-SARS-CoV-2 antibody levels and symptomatic breakthrough infection or hospitalization during the Omicron surge in kidney transplant recipients. Methods In total, 287 kidney transplant recipients expected to receive a third vaccination were enrolled between November 2021 and February 2022. The Abbott SARS-CoV-2 IgG II Quant test (Abbott, Chicago, IL, USA) was performed within three weeks before and four weeks after the third vaccination. The incidence of symptomatic breakthrough infection and hospitalization from two weeks to four months post-third vaccination was recorded. Results After the third vaccination, the seropositive rate and median antibody titer of the 287 patients increased from 57.1% to 82.2% and from 71.7 (interquartile range [IQR] 7.2-402.8) to 1,612.1 (IQR 153.9-5,489.1) AU/mL, respectively. Sixty-four (22.3%) patients had symptomatic breakthrough infections, of whom 12 required hospitalization. Lower anti-receptor-binding domain (RBD) IgG levels (<400 AU/mL) post-third vaccination were a risk factor for symptomatic breakthrough infection (hazard ratio [HR]=3.46, P<0.001). Anti-RBD IgG levels <200 AU/mL were a critical risk factor for hospitalization (HR=36.4, P=0.007). Conclusions Low anti-spike IgG levels after third vaccination in kidney transplant recipients were associated with symptomatic breakthrough infection and, particularly, with hospitalization during the Omicron surge. These data can be used to identify patients requiring additional protective measures, such as passive immunization using monoclonal antibodies.
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Affiliation(s)
- Ahram Han
- Department of Surgery, Seoul National University College of Medicine, Seoul, Korea
| | - Sangil Min
- Department of Surgery, Seoul National University College of Medicine, Seoul, Korea
| | - Eun-Ah Jo
- Department of Surgery, Seoul National University College of Medicine, Seoul, Korea
| | - Hajeong Lee
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Yong Chul Kim
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Seung Seok Han
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Hee Gyung Kang
- Department of Pediatrics, Seoul National University College of Medicine, Seoul, Korea
| | - Yo Han Ahn
- Department of Pediatrics, Seoul National University College of Medicine, Seoul, Korea
| | - Inseong Oh
- Department of Laboratory Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Eun Young Song
- Department of Laboratory Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Jongwon Ha
- Department of Surgery, Seoul National University College of Medicine, Seoul, Korea
- Transplantation Research Institute, Seoul National University College of Medicine, Seoul, Korea
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Woo HA, Kim SH, Ahn YH, Min SI, Ha J, Ha IS, Cheong HI, Kang HG. Clinical course of post-kidney transplant Schimke immuno-osseous dysplasia. Pediatr Transplant 2023; 27:e14605. [PMID: 37691539 DOI: 10.1111/petr.14605] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Revised: 01/02/2023] [Accepted: 08/18/2023] [Indexed: 09/12/2023]
Abstract
BACKGROUND Schimke immuno-osseous dysplasia (SIOD) is a rare systemic disease characterized by short stature, proteinuria, and recurrent infections. Patients usually have spondyloepiphyseal dysplasia, and progressive steroid-resistant nephropathy that leads to kidney failure. However, their clinical course after kidney transplantation (KT) is not yet well known. Here, we present our experience with cases of SIOD treated at our institute. CASE PRESENTATION Since 2014, three children have been diagnosed with nephropathy resulting from SIOD. They presented with proteinuria in the nephrotic range at 7, 5, and 3 years of age. Focal segmental glomerulosclerosis was confirmed and progressed to kidney failure approximately 2 years after proteinuria was detected. These patients underwent living-donor KT from their parents. After KT, Case 1 lost his graft within 7 months due to multi-organ failure caused by disseminated adenovirus infection and died. Case 2 experienced graft failure 5 years after KT due to acute rejection from poor compliance. In Case 3, the allograft was still functioning 6 years after KT with low-dose tacrolimus single medication (trough level < 5 ng/mL). Extra-renal manifestations progressed regardless of KT, namely, right renal vein thrombosis and pulmonary hypertension in Case 1, severe bilateral hip dysplasia and Moyamoya syndrome in Case 2, and neutropenia and thrombocytopenia in Case 3, in addition to recurrent infection. CONCLUSION In SIOD patients, KT is complicated with recurrent infections due to their inherent immune dysfunction. Additionally, extra-renal symptoms may render the patients morbid despite the recovery of kidney function.
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Affiliation(s)
- Hyun Ah Woo
- Department of Pediatrics, Seoul National University Hospital and Seoul National University College of Medicine, Seoul, Korea
| | - Seong Heon Kim
- Department of Pediatrics, Seoul National University Hospital and Seoul National University College of Medicine, Seoul, Korea
| | - Yo Han Ahn
- Department of Pediatrics, Seoul National University Hospital and Seoul National University College of Medicine, Seoul, Korea
| | - Sang Il Min
- Department of Surgery, Seoul National University Hospital and Seoul National University College of Medicine, Seoul, Korea
| | - Jongwon Ha
- Department of Surgery, Seoul National University Hospital and Seoul National University College of Medicine, Seoul, Korea
| | - Il-Soo Ha
- Department of Pediatrics, Seoul National University Hospital and Seoul National University College of Medicine, Seoul, Korea
| | - Hae Il Cheong
- Department of Pediatrics, Seoul National University Hospital and Seoul National University College of Medicine, Seoul, Korea
| | - Hee Gyung Kang
- Department of Pediatrics, Seoul National University Hospital and Seoul National University College of Medicine, Seoul, Korea
- Kidney Research Institute, Seoul National University Medical Research Center, Seoul, Korea
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Kim H, Han A, Ahn S, Min SK, Ha J, Min S. Association of high intra-patient variability in tacrolimus exposure with calcineurin inhibitor nephrotoxicity in kidney transplantation. Sci Rep 2023; 13:16502. [PMID: 37783764 PMCID: PMC10545770 DOI: 10.1038/s41598-023-43755-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Accepted: 09/27/2023] [Indexed: 10/04/2023] Open
Abstract
Tacrolimus intra-patient variability (IPV) is a novel predictive marker for long-term kidney transplantation outcomes. We examined the association between IPV and calcineurin inhibitor (CNI) nephrotoxicity and the impact of pharmacogenes on CNI nephrotoxicity and IPV. Among kidney transplant recipients at our hospital between January 2013 and December 2015, the records of 80 patients who underwent 1-year protocol renal allograft biopsy and agreed to donate blood samples for genetic analysis were retrospectively reviewed. The cohort was divided into the low and high IPV groups based on a coefficient variability cutoff value (26.5%). In multivariate analysis, the IPV group was involved in determining CNI nephrotoxicity (HR 4.55; 95% CI 0.05-0.95; p = 0.043). The 5-year graft survival was superior in the low IPV group than in the high IPV group (100% vs 92.4% respectively, p = 0.044). Analysis of the time above therapeutic range (TATR) showed higher CNI nephrotoxicity in the high IPV with high TATR group than in the low IPV with low TATR group (35.7% versus 6.7%, p = 0.003). Genetic analysis discovered that CYP3A4 polymorphism (rs2837159) was associated with CNI nephrotoxicity (HR 28.23; 95% CI 2.2-355.9; p = 0.01). In conclusion, high IPV and CYP3A4 polymorphisms (rs2837159) are associated with CNI nephrotoxicity.
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Affiliation(s)
- Hyokee Kim
- Department of Surgery, Korea University College of Medicine, Seoul, South Korea
| | - Ahram Han
- Department of Surgery, Seoul National University College of Medicine, Seoul, South Korea
| | - Sanghyun Ahn
- Department of Surgery, Seoul National University College of Medicine, Seoul, South Korea
| | - Seung-Kee Min
- Department of Surgery, Seoul National University College of Medicine, Seoul, South Korea
| | - Jongwon Ha
- Department of Surgery, Seoul National University College of Medicine, Seoul, South Korea
| | - Sangil Min
- Department of Surgery, Seoul National University College of Medicine, Seoul, South Korea.
- Division of Transplantation and Vascular Surgery, Department of Surgery, Seoul National University Hospital, 101, Daehak-ro, Jongno-gu, Seoul, 03080, South Korea.
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Min K, Han A, Jeong H, Han M, Kim H, Min S, Ha J. P6.1: Clinical presentation and outcomes of the COVID-19 infection in kidney transplant patients. Transplantation 2023; 107:94. [PMID: 37845997 DOI: 10.1097/01.tp.0000993568.24918.3b] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2023]
Affiliation(s)
- Kyungok Min
- Transplant Center, Seoul National University Hospital, Seoul, Korea
| | - Ahram Han
- Transplant Center, Seoul National University Hospital, Seoul, Korea
- Department of Surgery, Seoul Natoinal University Hospital, Seoul, Korea
- Department of Surgery, Seoul National University College of Medicine, Seoul, Korea
| | - Heami Jeong
- Transplant Center, Seoul National University Hospital, Seoul, Korea
| | - Miok Han
- Transplant Center, Seoul National University Hospital, Seoul, Korea
| | - Hyeonjeong Kim
- Transplant Center, Seoul National University Hospital, Seoul, Korea
| | - Sangil Min
- Transplant Center, Seoul National University Hospital, Seoul, Korea
- Department of Surgery, Seoul Natoinal University Hospital, Seoul, Korea
- Department of Surgery, Seoul National University College of Medicine, Seoul, Korea
| | - Jongwon Ha
- Transplant Center, Seoul National University Hospital, Seoul, Korea
- Department of Surgery, Seoul Natoinal University Hospital, Seoul, Korea
- Department of Surgery, Seoul National University College of Medicine, Seoul, Korea
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Min K, Han A, Jeong H, Han M, Kim H, Min S, Ha J. P5.6: Factors affecting the quality of life of living kidney donors in Korea. Transplantation 2023; 107:93. [PMID: 37845996 DOI: 10.1097/01.tp.0000993564.00179.f8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2023]
Affiliation(s)
- Kyungok Min
- Transplant Center, Seoul National University Hospital, Seoul, Korea
| | - Ahram Han
- Transplant Center, Seoul National University Hospital, Seoul, Korea
- Department of Surgery, Seoul Natoinal University Hospital, Seoul, Korea
- Department of Surgery, Seoul National University College of Medicine, Seoul, Korea
| | - Heami Jeong
- Transplant Center, Seoul National University Hospital, Seoul, Korea
| | - Miok Han
- Transplant Center, Seoul National University Hospital, Seoul, Korea
| | - Hyeonjeong Kim
- Transplant Center, Seoul National University Hospital, Seoul, Korea
| | - Sangil Min
- Transplant Center, Seoul National University Hospital, Seoul, Korea
- Department of Surgery, Seoul Natoinal University Hospital, Seoul, Korea
- Department of Surgery, Seoul National University College of Medicine, Seoul, Korea
| | - Jongwon Ha
- Transplant Center, Seoul National University Hospital, Seoul, Korea
- Department of Surgery, Seoul Natoinal University Hospital, Seoul, Korea
- Department of Surgery, Seoul National University College of Medicine, Seoul, Korea
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Kim Y, Kim JT, Yang SM, Kim WH, Han A, Ha J, Min S, Park SK. Anterior quadratus lumborum block for analgesia after living-donor renal transplantation: a double-blinded randomized controlled trial. Reg Anesth Pain Med 2023:rapm-2023-104788. [PMID: 37704438 DOI: 10.1136/rapm-2023-104788] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Accepted: 08/29/2023] [Indexed: 09/15/2023]
Abstract
INTRODUCTION Limited non-opioid analgesic options are available for managing postoperative pain after renal transplantation. We aimed to investigate whether the unilateral anterior quadratus lumborum (QL) block would reduce postoperative opioid consumption after living-donor renal transplantation in the context of multimodal analgesia. METHODS Eighty-eight adult patients undergoing living-donor renal transplantation were randomly allocated to receive the unilateral anterior QL block (30 mL of ropivacaine 0.375%) or sham block (normal saline) on the operated side before emergence from anesthesia. All patients received standard multimodal analgesia, including the scheduled administration of acetaminophen and fentanyl via intravenous patient-controlled analgesia. The primary outcome was the total opioid consumption during the first 24 hours after transplantation. The secondary outcomes included pain scores, time to first opioid administration, cutaneous distribution of sensory blockade, motor weakness, nausea/vomiting, quality of recovery scores, time to first ambulation, and length of hospital stay. RESULTS The total opioid consumption in the first 24 hours after transplantation did not differ significantly between the intervention and control groups (median (IQR), 160.5 (78-249.8) vs 187.5 (93-309) oral morphine milligram equivalent; median difference (95% CI), -27 (-78 to 24), p=0.29). No differences were observed in the secondary outcomes. CONCLUSIONS The anterior QL block did not reduce opioid consumption in patients receiving multimodal analgesia after living-donor renal transplantation. Our findings do not support the routine administration of the anterior QL block in this surgical population. TRIAL REGISTRATION NUMBER NCT04908761.
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Affiliation(s)
- Youngwon Kim
- Department of Anesthesiology and Pain Medicine and Anesthesia and Pain Research Institute, Yonsei University College of Medicine, Seoul, Korea (the Republic of)
| | - Jin-Tae Kim
- Department of Anesthesiology and Pain Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea (the Republic of)
| | - Seong-Mi Yang
- Department of Anesthesiology and Pain Medicine, Asan Medical Center, Ulsan University College of Medicine, Seoul, Korea (the Republic of)
| | - Won Ho Kim
- Department of Anesthesiology and Pain Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea (the Republic of)
| | - Ahram Han
- Department of Surgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea (the Republic of)
| | - Jongwon Ha
- Department of Surgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea (the Republic of)
| | - Sangil Min
- Department of Surgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea (the Republic of)
| | - Sun-Kyung Park
- Department of Anesthesiology and Pain Medicine and Anesthesia and Pain Research Institute, Yonsei University College of Medicine, Seoul, Korea (the Republic of)
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Yeom GE, Lim SH, Kim JH, Ahn YH, Kim H, Ha J, Kim HY, Kang HG. Gastrointestinal involvement of passenger lymphocyte syndrome followed by minor ABO-incompatible renal transplantation: A case report. Pediatr Transplant 2023; 27:e14556. [PMID: 37300335 DOI: 10.1111/petr.14556] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Revised: 05/02/2023] [Accepted: 05/22/2023] [Indexed: 06/12/2023]
Abstract
BACKGROUND People with group O blood are considered universal organ donors compatible with any other blood group. However, in the case of minor ABO-incompatible transplantation, immune-mediated hemolysis may occur due to concomitant transfer of donor B lymphocytes together with the allograft. These passenger lymphocytes can produce antibodies in the recipients erythrocytes, causing hemolytic anemia known as passenger lymphocyte syndrome (PLS). METHODS A retrospective chart review was performed. RESULTS A 6-year-old boy (A+) underwent transplantation of a kidney from his father (O+). On postoperative day (POD) 6, the patient developed fever with no explainable causes. On POD 11, he presented with abdominal pain, hematochezia, and severe diarrhea, with sudden hemolytic anemia. Since then, GI symptoms have continued. On POD 20, direct antiglobulin test (DAT) was positive, and the anti-A IgM/G titer was 2/32. The results of the anti-A antibody elution test were strongly positive (3+). These findings highly suggested PLS. On the same day, the GI symptoms suddenly worsened, and laboratory findings showed hemolysis and thrombocytopenia with disseminated intravascular coagulation (DIC). Abdominal computed tomography (CT) scans suggested ischemic colitis of venous origin, and the patient underwent segmental colectomy with ileostomy formation on POD 23. To remove the anti-A antibodies, the patient underwent therapeutic plasma exchange (TPE) five times until the DAT and anti-A elution test were negative. CONCLUSIONS We report a case of gastrointestinal involvement of PLS that occurred after minor ABO-incompatible kidney transplantation. This is the first report of ischemic colitis as an atypical manifestation of PLS.
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Affiliation(s)
- Gyeong Eun Yeom
- Departments of Pediatrics, Seoul National University Children's Hospital, Seoul, South Korea
| | - Seon Hee Lim
- Department of Pediatrics, Pusan National University Children's Hospital and School of Medicine, Yangsan, Republic of Korea
| | - Ji Hyun Kim
- Departments of Pediatrics, Seoul National University Bundang Hospital, Seongnam-si, South Korea
| | - Yo Han Ahn
- Departments of Pediatrics, Seoul National University Children's Hospital, Seoul, South Korea
| | - Hyungsuk Kim
- Department of Laboratory Medicine, Seoul National University Hospital, Seoul, South Korea
| | - Jongwon Ha
- The Transplantation Research Institute, Seoul National University College of Medicine, Seoul, South Korea
| | - Hyun-Young Kim
- Department of Pediatric Surgery, Seoul National University Children's Hospital, Seoul, South Korea
| | - Hee Gyung Kang
- Departments of Pediatrics, Seoul National University Children's Hospital, Seoul, South Korea
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Casillan A, Larson E, Ruck J, Zhou A, Ha J, Shah P, Merlo C, Bush E. Combined Lung-Kidney Transplantation Yields Better Survival Than Isolated Lung Transplantation in Recipients with Underlying Renal Failure. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.1037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2023] Open
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Abstract
BACKGROUND The bovine pericardium is a good alternative material to the autogenous vein in vascular reconstruction. This study aimed to evaluate the results of angioplasty in venous reconstruction using bovine pericardium and identify the risk factors for significant complications. MATERIAL AND METHODS A retrospective review was performed of the demographic data, clinical characteristics, and complications of patients who underwent vessel repair using bovine pericardium between February 2012 and December 2020. Univariate analysis was used to compare complication frequencies within several categories. RESULTS There were 36 cases of patch angioplasty using bovine pericardium. The median age was 65 years; 61% of them were men. Of the 36 venous repairs, 31 (86.1%) were from cancer surgery and five (13.9%) were from iatrogenic injury. Patch shape was used in 27 cases (75.0%), while tube shape was used in nine cases (25.0%). The incidence of occlusion and partial thrombus was five (13.9%) and three (8.3%) cases, respectively. Of the nine tube-shaped angioplasties, four (44.4%) required reoperation due to early thrombosis (three cases) and hematoma (one case). CONCLUSION The use of a bovine pericardial patch in the reconstruction of a damaged vein from tumor invasion or iatrogenic injury is feasible. However, the complication rate of vessel patency remains substantial, especially in cases of iatrogenic injury or when a tube-shaped form is used for repair.
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Affiliation(s)
- Jong-Sung Ahn
- Division of Vascular Surgery, Department of Surgery, 58927Seoul National University College of Medicined, Jongno-gu, South Korea
| | - Hyejin Mo
- Department of Surgery, Seoul Metropolitan Government - 58927Seoul National University Boramae Medical Center, Seoul, South Korea
| | - Sanghyun Ahn
- Division of Vascular Surgery, Department of Surgery, 58927Seoul National University College of Medicined, Jongno-gu, South Korea
| | - Ahram Han
- Division of Vascular Surgery, Department of Surgery, 58927Seoul National University College of Medicined, Jongno-gu, South Korea
| | - Sangil Min
- Division of Vascular Surgery, Department of Surgery, 58927Seoul National University College of Medicined, Jongno-gu, South Korea
| | - Seung-Kee Min
- Division of Vascular Surgery, Department of Surgery, 58927Seoul National University College of Medicined, Jongno-gu, South Korea
| | - Jongwon Ha
- Division of Vascular Surgery, Department of Surgery, 58927Seoul National University College of Medicined, Jongno-gu, South Korea.,Transplantation Research Institute, 58927Seoul National University College of Medicine, Seoul, South Korea
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Kim JY, Han A, Lee H, Ha J, Lee KW, Suh KS, Yi NJ, Min S, Hong SK, Kim YC, Choi Y, Yim JJ, Kwak N. The Clinical Course and Prognosis of Patients With Nontuberculous Mycobacterial Pulmonary Disease After Solid Organ Transplantation. J Korean Med Sci 2023; 38:e46. [PMID: 36786088 PMCID: PMC9925332 DOI: 10.3346/jkms.2023.38.e46] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2022] [Accepted: 11/14/2022] [Indexed: 02/03/2023] Open
Abstract
BACKGROUND Due to impaired cell-mediated immunity, solid organ transplantation (SOT) recipients are at increased risk of developing nontuberculous mycobacterial pulmonary disease (NTM-PD). However, the clinical course of NTM-PD in SOT patients and the impact of SOT on the prognosis of NTM-PD remain unclear. METHODS We analyzed patients who developed NTM-PD after receiving SOT between January 2001 and December 2020, at a tertiary referral hospital in South Korea. Baseline characteristics, clinical course, and prognosis were evaluated. Propensity score-matched analysis was performed to assess the impact of SOT on long-term survival in patients with NTM-PD. RESULTS Among 4,685 SOT recipients over 20 years, 12 patients (median age, 64 years; interquartile range [IQR], 59-67 years; men, 66.7%) developed NTM-PD. Seven (58.3%) and five (41.7%) patients underwent kidney and liver transplantation, respectively, before the diagnosis of NTM-PD. The incidence of NTM-PD was 35.6 cases per 100,000 person-years among kidney transplant recipients and 28.7 cases per 100,000 person-years among liver transplant recipients. The median time between transplantation and the diagnosis of NTM-PD was 3.3 (IQR, 1.5-10.8) years. The most common mycobacterial species was Mycobacterium avium (50.0%). Antibiotic treatment was initiated in five (41.7%) patients, and two patients (40.0%) achieved microbiological cure. Two patients died during a median follow-up of 4.2 (IQR, 2.3-8.8) years and NTM-PD was assumed to be the cause of death in one patient. When matched to patients without a history of SOT, patients with a history of SOT did not show worse survival (P value for log-rank test = 0.62). CONCLUSION The clinical course of NTM-PD in SOT recipients was comparable to that of patients without SOT, and SOT did not increase the risk of all-cause mortality in patients with NTM-PD.
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Affiliation(s)
- Joong-Yub Kim
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Ahram Han
- Department of Surgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Hajeong Lee
- Division of Nephrology, Department of Internal Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Jongwon Ha
- Department of Surgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
- Transplantation Research Institute, Seoul National University College of Medicine, Seoul, Korea
| | - Kwang-Woong Lee
- Department of Surgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Kyung-Suk Suh
- Department of Surgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Nam-Joon Yi
- Department of Surgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Sangil Min
- Department of Surgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Suk Kyun Hong
- Department of Surgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Yong Chul Kim
- Division of Nephrology, Department of Internal Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - YoungRok Choi
- Department of Surgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Jae-Joon Yim
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Nakwon Kwak
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea.
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Jo EA, Min S, Jang Y, Kim YC, Kim JS, Han A, Ha J. Development of an AI model for kidney cortex volumetry for donor evaluation. Korean Journal of Transplantation 2022. [DOI: 10.4285/atw2022.f-2796] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- Eun-Ah Jo
- Department of Surgery, Seoul National University Hospital, Seoul, Korea
| | - Sangil Min
- Department of Surgery, Seoul National University Hospital, Seoul, Korea
| | - Yunyoung Jang
- Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea
| | - Yong Chul Kim
- Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea
| | - Jin Sung Kim
- Department of Radiation Oncology, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Ahram Han
- Department of Surgery, Seoul National University Hospital, Seoul, Korea
| | - Jongwon Ha
- Department of Surgery, Seoul National University Hospital, Seoul, Korea
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14
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Kim J, Park S, Cho H, Park JI, Han A, Min S, Ha J, Kim YS, Lee H. A potential role of gut microbiome in predicting of early acute rejection after kidney transplantation. Korean Journal of Transplantation 2022. [DOI: 10.4285/atw2022.f-4075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- Jieun Kim
- Division of Nephrology, Department of Internal Medicine, Korea University Guro Hospital, Seoul, Korea
| | - Sehoon Park
- Division of Nephrology, Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea
| | - Hyunjeong Cho
- Division of Nephrology, Department of Internal Medicine, Chungbuk National University Hospital, Cheongju, Korea
| | - Ji In Park
- Division of Nephrology, Department of Internal Medicine, Kangwon National University Hospital, Chuncheon, Korea
| | - Ahram Han
- Department of Transplantation Surgery, Seoul National University Hospital, Seoul, Korea
| | - Sangil Min
- Department of Transplantation Surgery, Seoul National University Hospital, Seoul, Korea
| | - Jongwon Ha
- Department of Transplantation Surgery, Seoul National University Hospital, Seoul, Korea
| | - Yon Su Kim
- Division of Nephrology, Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea
| | - Hajeong Lee
- Division of Nephrology, Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea
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Cho A, Woo HY, Jo EA, Han A, Min S, Ha J. BK viremia after kidney transplantation: efficacy of stepwise treatment. Korean Journal of Transplantation 2022. [DOI: 10.4285/atw2022.f-3691] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- Ara Cho
- Department of Surgery, Seoul National University Hospital, Seoul, Korea
| | - Hye Young Woo
- Department of Surgery, Seoul National University Hospital, Seoul, Korea
| | - Eun-Ah Jo
- Department of Surgery, Seoul National University Hospital, Seoul, Korea
| | - Ahram Han
- Department of Surgery, Seoul National University Hospital, Seoul, Korea
| | - Sangil Min
- Department of Surgery, Seoul National University Hospital, Seoul, Korea
| | - Jongwon Ha
- Department of Surgery, Seoul National University Hospital, Seoul, Korea
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16
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Jo EA, Min S, Han A, Ha J, Cho A, Woo HY. Detecting high risk patients for new-onset diabetes after transplantation after kidney transplantation using continuous glucose monitoring device. Korean Journal of Transplantation 2022. [DOI: 10.4285/atw2022.f-2779] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- Eun-Ah Jo
- Department of Surgery, Seoul National University Hospital, Seoul, Korea
| | - Sangil Min
- Department of Surgery, Seoul National University Hospital, Seoul, Korea
| | - Ahram Han
- Department of Surgery, Seoul National University Hospital, Seoul, Korea
| | - Jongwon Ha
- Department of Surgery, Seoul National University Hospital, Seoul, Korea
| | - Ara Cho
- Department of Surgery, Seoul National University Hospital, Seoul, Korea
| | - Hye Young Woo
- Department of Surgery, Seoul National University Hospital, Seoul, Korea
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17
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Woo HY, Min SI, Han A, Ha J. Visualization of ischemia reperfusion injury of kidney and prediction of early allograft dysfunction after kidney transplantation using cysteine probe. Korean Journal of Transplantation 2022. [DOI: 10.4285/atw2022.f-1014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- Hye Young Woo
- Department of Surgery, Seoul National University Hospital, Seoul, Korea
| | - Sang-il Min
- Department of Surgery, Seoul National University Hospital, Seoul, Korea
| | - Ahram Han
- Department of Surgery, Seoul National University Hospital, Seoul, Korea
| | - Jongwon Ha
- Department of Surgery, Seoul National University Hospital, Seoul, Korea
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Jang Y, Jo EA, Chun J, Moon S, Kim JS, Han A, Ha J, Lee H, Kim YC, Min S. AI model for the segmentation of skeletal muscle, visceral and subcutaneous fat at L3 level using donor CT. Korean Journal of Transplantation 2022. [DOI: 10.4285/atw2022.f-2116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- Yunyoung Jang
- Department of Nephrology, Seoul National University Hospital, Seoul, Korea
| | - Eun-Ah Jo
- Department of Transplantation Surgery, Seoul National University Hospital, Seoul, Korea
| | - Jaehee Chun
- Department of Radiation Oncology, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Seonggong Moon
- Department of Radiation Oncology, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Jin Sung Kim
- Department of Radiation Oncology, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Ahram Han
- Department of Transplantation Surgery, Seoul National University Hospital, Seoul, Korea
| | - Jongwon Ha
- Department of Transplantation Surgery, Seoul National University Hospital, Seoul, Korea
| | - Hajeong Lee
- Department of Nephrology, Seoul National University Hospital, Seoul, Korea
| | - Yong Chul Kim
- Department of Nephrology, Seoul National University Hospital, Seoul, Korea
| | - Sangil Min
- Department of Transplantation Surgery, Seoul National University Hospital, Seoul, Korea
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19
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Min K, Han M, Jeong H, Kim H, Kim O, Lee S, Lee S, Kim J, Han A, Ha J. Clinical presentation and outcomes of the COVID-19 infection in kidney transplant patients. Korean Journal of Transplantation 2022. [DOI: 10.4285/atw2022.f-4427] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- Kyungok Min
- Transplantation Center, Seoul National University Hospital, Seoul, Korea
| | - Miok Han
- Transplantation Center, Seoul National University Hospital, Seoul, Korea
| | - Heami Jeong
- Transplantation Center, Seoul National University Hospital, Seoul, Korea
| | - Hyeonjeong Kim
- Transplantation Center, Seoul National University Hospital, Seoul, Korea
| | - Okkyung Kim
- Transplantation Center, Seoul National University Hospital, Seoul, Korea
| | - Seoyeon Lee
- Transplantation Center, Seoul National University Hospital, Seoul, Korea
| | - Seunghyun Lee
- Transplantation Center, Seoul National University Hospital, Seoul, Korea
| | - Juhee Kim
- Transplantation Center, Seoul National University Hospital, Seoul, Korea
| | - Ahram Han
- Transplantation Center, Seoul National University Hospital, Seoul, Korea
| | - Jongwon Ha
- Transplantation Center, Seoul National University Hospital, Seoul, Korea
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20
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Han A, Min S, Lee H, Kim YC, Kang HK, Ahn YH, Song EY, Ha J. Anti-spike antibody titer in kidney transplant recipients after the third dose of SARS-CoV-2 vaccination correlates with the incidence and severity of breakthrough infection during the Omicron surge. Korean Journal of Transplantation 2022. [DOI: 10.4285/atw2022.f-4583] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- Ahram Han
- Department of Surgery, Seoul National University Hospital, Seoul, Korea
| | - Sangil Min
- Department of Surgery, Seoul National University Hospital, Seoul, Korea
| | - Hajeong Lee
- Department of Nephrology, Seoul National University Hospital, Seoul, Korea
| | - Yong Chul Kim
- Department of Nephrology, Seoul National University Hospital, Seoul, Korea
| | - Hee Kyung Kang
- Department of Pediatrics, Seoul National University Hospital, Seoul, Korea
| | - Yo Han Ahn
- Department of Pediatrics, Seoul National University Hospital, Seoul, Korea
| | - Eun Young Song
- Department of Laboratory Medicine, Seoul National University Hospital, Seoul, Korea
| | - Jongwon Ha
- Department of Surgery, Seoul National University Hospital, Seoul, Korea
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21
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Mao S, Rosner S, Forde P, Chaft J, Jones D, Spicer J, Hales R, Ha J, Hu C, Voong R. Patterns of Failure in Resectable Stage I-IIIA NSCLC Treated with Neoadjuvant Immunotherapy Combinations, a Secondary Analysis of a Prospective Trial. Int J Radiat Oncol Biol Phys 2022. [DOI: 10.1016/j.ijrobp.2022.07.1527] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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22
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Phong VH, Nishimura S, Lorusso G, Davinson T, Estrade A, Hall O, Kawano T, Liu J, Montes F, Nishimura N, Grzywacz R, Rykaczewski KP, Agramunt J, Ahn DS, Algora A, Allmond JM, Baba H, Bae S, Brewer NT, Bruno CG, Caballero-Folch R, Calviño F, Coleman-Smith PJ, Cortes G, Dillmann I, Domingo-Pardo C, Fijalkowska A, Fukuda N, Go S, Griffin CJ, Ha J, Harkness-Brennan LJ, Isobe T, Kahl D, Khiem LH, Kiss GG, Korgul A, Kubono S, Labiche M, Lazarus I, Liang J, Liu Z, Matsui K, Miernik K, Moon B, Morales AI, Morrall P, Nepal N, Page RD, Piersa-Siłkowska M, Pucknell VFE, Rasco BC, Rubio B, Sakurai H, Shimizu Y, Stracener DW, Sumikama T, Suzuki H, Tain JL, Takeda H, Tarifeño-Saldivia A, Tolosa-Delgado A, Wolińska-Cichocka M, Woods PJ, Yokoyama R. β-Delayed One and Two Neutron Emission Probabilities Southeast of ^{132}Sn and the Odd-Even Systematics in r-Process Nuclide Abundances. Phys Rev Lett 2022; 129:172701. [PMID: 36332266 DOI: 10.1103/physrevlett.129.172701] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/04/2022] [Revised: 07/30/2022] [Accepted: 08/25/2022] [Indexed: 06/16/2023]
Abstract
The β-delayed one- and two-neutron emission probabilities (P_{1n} and P_{2n}) of 20 neutron-rich nuclei with N≥82 have been measured at the RIBF facility of the RIKEN Nishina Center. P_{1n} of ^{130,131}Ag, ^{133,134}Cd, ^{135,136}In, and ^{138,139}Sn were determined for the first time, and stringent upper limits were placed on P_{2n} for nearly all cases. β-delayed two-neutron emission (β2n) was unambiguously identified in ^{133}Cd and ^{135,136}In, and their P_{2n} were measured. Weak β2n was also detected from ^{137,138}Sn. Our results highlight the effect of the N=82 and Z=50 shell closures on β-delayed neutron emission probability and provide stringent benchmarks for newly developed macroscopic-microscopic and self-consistent global models with the inclusion of a statistical treatment of neutron and γ emission. The impact of our measurements on r-process nucleosynthesis was studied in a neutron star merger scenario. Our P_{1n} and P_{2n} have a direct impact on the odd-even staggering of the final abundance, improving the agreement between calculated and observed Solar System abundances. The odd isotope fraction of Ba in r-process-enhanced (r-II) stars is also better reproduced using our new data.
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Affiliation(s)
- V H Phong
- RIKEN Nishina Center, Wako, Saitama 351-0198, Japan
- University of Science, Vietnam National University, Hanoi 120062, Vietnam
| | - S Nishimura
- RIKEN Nishina Center, Wako, Saitama 351-0198, Japan
| | - G Lorusso
- RIKEN Nishina Center, Wako, Saitama 351-0198, Japan
- National Physical Laboratory, Teddington TW11 0LW, United Kingdom
- Department of Physics, University of Surrey, Guildford GU2 7XH, United Kingdom
| | - T Davinson
- School of Physics and Astronomy, University of Edinburgh, Edinburgh EH9 3FD, United Kingdom
| | - A Estrade
- Department of Physics, Central Michigan University, Mount Pleasant, Michigan 48859, USA
| | - O Hall
- School of Physics and Astronomy, University of Edinburgh, Edinburgh EH9 3FD, United Kingdom
| | - T Kawano
- Theoretical Division, Los Alamos National Laboratory, Los Alamos, New Mexico 87545, USA
| | - J Liu
- RIKEN Nishina Center, Wako, Saitama 351-0198, Japan
- Department of Physics, University of Hong Kong, Pokfulman Road, Hong Kong
| | - F Montes
- National Superconducting Cyclotron Laboratory, East Lansing, Michigan 48824, USA
| | - N Nishimura
- RIKEN Nishina Center, Wako, Saitama 351-0198, Japan
- Astrophysical Big-Bang Laboratory, Cluster for Pioneering Research, RIKEN, Wako, Saitama 351-0198, Japan
| | - R Grzywacz
- Department of Physics and Astronomy, University of Tennessee, Knoxville, Tennessee 37996, USA
| | - K P Rykaczewski
- Physics Division, Oak Ridge National Laboratory, Oak Ridge, Tennessee 37831, USA
| | - J Agramunt
- Instituto de Fsica Corpuscular, CSIC and Universitat de Valencia, E-46980 Paterna, Spain
| | - D S Ahn
- RIKEN Nishina Center, Wako, Saitama 351-0198, Japan
- Center for Exotic Nuclear Studies, Institute for Basic Science, Daejeon 34126, Republic of Korea
| | - A Algora
- Instituto de Fsica Corpuscular, CSIC and Universitat de Valencia, E-46980 Paterna, Spain
| | - J M Allmond
- Physics Division, Oak Ridge National Laboratory, Oak Ridge, Tennessee 37831, USA
| | - H Baba
- RIKEN Nishina Center, Wako, Saitama 351-0198, Japan
| | - S Bae
- Center for Exotic Nuclear Studies, Institute for Basic Science, Daejeon 34126, Republic of Korea
| | - N T Brewer
- Department of Physics and Astronomy, University of Tennessee, Knoxville, Tennessee 37996, USA
- Physics Division, Oak Ridge National Laboratory, Oak Ridge, Tennessee 37831, USA
| | - C G Bruno
- School of Physics and Astronomy, University of Edinburgh, Edinburgh EH9 3FD, United Kingdom
| | | | - F Calviño
- Universitat Politecnica de Catalunya, E-08028 Barcelona, Spain
| | - P J Coleman-Smith
- STFC Daresbury Laboratory, Daresbury, Warrington WA4 4AD, United Kingdom
| | - G Cortes
- Universitat Politecnica de Catalunya, E-08028 Barcelona, Spain
| | - I Dillmann
- TRIUMF, Vancouver, British Columbia V6T 2A3, Canada
- Department of Physics and Astronomy, University of Victoria, Victoria, British Columbia V8P 5C2, Canada
| | - C Domingo-Pardo
- Instituto de Fsica Corpuscular, CSIC and Universitat de Valencia, E-46980 Paterna, Spain
| | - A Fijalkowska
- Faculty of Physics, University of Warsaw, PL02-093 Warsaw, Poland
| | - N Fukuda
- RIKEN Nishina Center, Wako, Saitama 351-0198, Japan
| | - S Go
- RIKEN Nishina Center, Wako, Saitama 351-0198, Japan
| | - C J Griffin
- School of Physics and Astronomy, University of Edinburgh, Edinburgh EH9 3FD, United Kingdom
| | - J Ha
- RIKEN Nishina Center, Wako, Saitama 351-0198, Japan
- Seoul National University, Department of Physics and Astronomy, Seoul 08826, Republic of Korea
| | - L J Harkness-Brennan
- Department of Physics, University of Liverpool, Liverpool L69 7ZE, United Kingdom
| | - T Isobe
- RIKEN Nishina Center, Wako, Saitama 351-0198, Japan
| | - D Kahl
- School of Physics and Astronomy, University of Edinburgh, Edinburgh EH9 3FD, United Kingdom
- Extreme Light Infrastructure-Nuclear Physics, Horia Hulubei National Institute for R&D in Physics and Nuclear Engineering (IFIN-HH), 077125 Bucharest-Măgurele, Romania
| | - L H Khiem
- Institute of Physics, Vietnam Academy of Science and Technology, Ba Dinh, 118011 Hanoi, Vietnam
- Graduate University of Science and Technology, Vietnam Academy of Science and Technology, Cau Giay, 122102 Hanoi, Vietnam
| | - G G Kiss
- RIKEN Nishina Center, Wako, Saitama 351-0198, Japan
- Institute for Nuclear Research (Atomki), Debrecen H4032, Hungary
| | - A Korgul
- Faculty of Physics, University of Warsaw, PL02-093 Warsaw, Poland
| | - S Kubono
- RIKEN Nishina Center, Wako, Saitama 351-0198, Japan
| | - M Labiche
- STFC Daresbury Laboratory, Daresbury, Warrington WA4 4AD, United Kingdom
| | - I Lazarus
- STFC Daresbury Laboratory, Daresbury, Warrington WA4 4AD, United Kingdom
| | - J Liang
- McMaster University, Department of Physics and Astronomy, Hamilton, Ontario L8S 4M1, Canada
| | - Z Liu
- Institute of Modern Physics, Chinese Academy of Sciences, Lanzhou 730000, China
- School of Nuclear Science and Technology, University of Chinese Academy of Sciences, Beijing 100049, China
| | - K Matsui
- RIKEN Nishina Center, Wako, Saitama 351-0198, Japan
- University of Tokyo, Department of Physics, Tokyo 113-0033, Japan
| | - K Miernik
- Faculty of Physics, University of Warsaw, PL02-093 Warsaw, Poland
| | - B Moon
- Center for Exotic Nuclear Studies, Institute for Basic Science, Daejeon 34126, Republic of Korea
| | - A I Morales
- Instituto de Fsica Corpuscular, CSIC and Universitat de Valencia, E-46980 Paterna, Spain
| | - P Morrall
- STFC Daresbury Laboratory, Daresbury, Warrington WA4 4AD, United Kingdom
| | - N Nepal
- Department of Physics, Central Michigan University, Mount Pleasant, Michigan 48859, USA
| | - R D Page
- Department of Physics, University of Liverpool, Liverpool L69 7ZE, United Kingdom
| | | | - V F E Pucknell
- STFC Daresbury Laboratory, Daresbury, Warrington WA4 4AD, United Kingdom
| | - B C Rasco
- Physics Division, Oak Ridge National Laboratory, Oak Ridge, Tennessee 37831, USA
| | - B Rubio
- Instituto de Fsica Corpuscular, CSIC and Universitat de Valencia, E-46980 Paterna, Spain
| | - H Sakurai
- RIKEN Nishina Center, Wako, Saitama 351-0198, Japan
- University of Tokyo, Department of Physics, Tokyo 113-0033, Japan
| | - Y Shimizu
- RIKEN Nishina Center, Wako, Saitama 351-0198, Japan
| | - D W Stracener
- Physics Division, Oak Ridge National Laboratory, Oak Ridge, Tennessee 37831, USA
| | - T Sumikama
- RIKEN Nishina Center, Wako, Saitama 351-0198, Japan
| | - H Suzuki
- RIKEN Nishina Center, Wako, Saitama 351-0198, Japan
| | - J L Tain
- Instituto de Fsica Corpuscular, CSIC and Universitat de Valencia, E-46980 Paterna, Spain
| | - H Takeda
- RIKEN Nishina Center, Wako, Saitama 351-0198, Japan
| | - A Tarifeño-Saldivia
- Instituto de Fsica Corpuscular, CSIC and Universitat de Valencia, E-46980 Paterna, Spain
- Universitat Politecnica de Catalunya, E-08028 Barcelona, Spain
| | - A Tolosa-Delgado
- Instituto de Fsica Corpuscular, CSIC and Universitat de Valencia, E-46980 Paterna, Spain
| | - M Wolińska-Cichocka
- Heavy Ion Laboratory, University of Warsaw, Pasteura 5A, PL-02-093 Warsaw, Poland
| | - P J Woods
- School of Physics and Astronomy, University of Edinburgh, Edinburgh EH9 3FD, United Kingdom
| | - R Yokoyama
- Department of Physics and Astronomy, University of Tennessee, Knoxville, Tennessee 37996, USA
- Center for Nuclear Study, University of Tokyo, RIKEN Campus, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
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23
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Jin U, Lee CJ, Yoon M, Ha J, Oh J, Park S, Lee SH, Kang SM. The association between frailty and physical performance in elderly patients with heart failure. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.1062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Frailty is known to be an important prognostic indicator in heart failure (HF). The Korean version of the frail scale for Koreans (K-FRAIL) has been developed and verified. The purpose of this study is to analyze the relationship between the K-FRAIL scale and physical performance, including muscular fitness and aerobic capacity in patients with HF.
Methods
This study included 143 HF patients aged over 65 years from a single tertiary hospital. In these subjects, muscular fitness was assessed using the handgrip test and knee extensor strength measurement, and aerobic capacity was assessed by cardiopulmonary exercise test and 6-minute walk test. Frailty status was measured using the K-FRAIL questionnaire and was classified as robust (K-FRAIL scale: 0), prefrail (1–2), and frail (3–5).
Results
Mean age of participants with robust (N=37), prefrail (N=75), and frail (N=31) were 72.5, 73.5, and 76.3 years, respectively. There was no difference in sex and left ventricular ejection fraction (LVEF) among groups, but the estimated glomerular filtration rate (eGFR) was significantly lower as frailty status increased (75.6±17.2 vs. 70.0±20.5 vs. 56.1±23.7 mL/min/1.73 m2; P<0.001). Hand-grip strength and knee extensor muscle strength did not differ among groups. However, peak oxygen consumption (peak VO2; 22.8±5.0 vs. 19.3±4.6 vs. 16.9±4.7 mL/kg/min, P<0.001) and 6-min walk distance (458.4±68.2 vs. 404.5±92.3 vs. 311.2±120.5 m; p<0.001) significantly decreased according to frailty severity. In multivariate regression analysis adjusted for age, sex, haemoglobin, eGFR and LVEF, peak VO2 (β=−0.311; P=0.002) and 6-min walk distance (β=−0.384; P<0.001) showed a significant inverse association with the K-FRAIL scale. With the cut-off value from receiver-operating characteristic curve analysis, peak VO2 (hazard ratio, 5.08; p=0.023) and 6MWT (hazard ratio, 3.99; p=0.020) were independent predictor of frailty according to K-FRAIL scale.
Conclusion
In elderly HF patients, physical performance differs according to frailty status, peak VO2 and 6-min walk distance correlates with the K-FRAIL scale better than muscular fitness.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- U Jin
- Ajou University School of Medicine, Department of Cardiology , Suwon , Korea (Republic of)
| | - C J Lee
- Yonsei University College of Medicine, Division of Cardiology, Severance Cardiovascular Hospital and Cardiovascular Research Institute , Seoul , Korea (Republic of)
| | - M Yoon
- Seoul National University Bundang Hospital, Department of Cardiology , Seongnam , Korea (Republic of)
| | - J Ha
- Yonsei University College of Medicine, Division of Cardiology, Severance Cardiovascular Hospital and Cardiovascular Research Institute , Seoul , Korea (Republic of)
| | - J Oh
- Yonsei University College of Medicine, Division of Cardiology, Severance Cardiovascular Hospital and Cardiovascular Research Institute , Seoul , Korea (Republic of)
| | - S Park
- Yonsei University College of Medicine, Division of Cardiology, Severance Cardiovascular Hospital and Cardiovascular Research Institute , Seoul , Korea (Republic of)
| | - S H Lee
- Yonsei University College of Medicine, Division of Cardiology, Severance Cardiovascular Hospital and Cardiovascular Research Institute , Seoul , Korea (Republic of)
| | - S M Kang
- Yonsei University College of Medicine, Division of Cardiology, Severance Cardiovascular Hospital and Cardiovascular Research Institute , Seoul , Korea (Republic of)
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24
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Jo EA, Kim HK, Min S, Moon KC, Han A, Ahn S, Min SK, Ha J. The appearance of C1q deposition in transplanted kidney allografts and its clinical and histopathologic features. Korean J Transplant 2022; 36:180-186. [PMID: 36275987 PMCID: PMC9574431 DOI: 10.4285/kjt.22.0032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Revised: 07/25/2022] [Accepted: 07/29/2022] [Indexed: 11/18/2022] Open
Abstract
Background C1q nephropathy is an uncommon type of glomerulonephritis characterized by extensive and dominant C1q mesangial deposition in the absence of systemic lupus erythematosus. However, there are limited studies about C1q deposition in renal allografts. This study aimed to report the prevalence of C1q deposition in transplanted kidney allograft biopsies and describe its clinical and histopathologic features. Methods Between January 2005 and December 2018, a total of 1,742 kidney transplantations were performed at Seoul National University Hospital. All renal allograft biopsies (n=10,217) of these patients were retrospectively screened for C1q deposition. C1q deposition was detected in the renal allograft biopsies of 104 patients (6.0%). Only 28 cases (1.6%) had intense (≥2+) C1q dominance and were reviewed in this study. Results Among the 28 cases, only four (14.3%) had accompanying proliferative glomerulonephritis. Most did not have any other glomerular changes on light microscopy. No patients had nephrotic-range proteinuria at the time of biopsy. A follow-up biopsy was undertaken in 15 of the cases (53.6%). In these follow-up biopsies, C1q deposition either completely disappeared (n=13, 86.7%) or showed diminished staining (n=2, 13.3%). Conclusions The prevalence of dominant or codominant C1q deposition in transplanted renal allograft biopsies was 1.6%. Most cases did not have any other accompanying glomerular changes. The follow-up biopsies of these allografts showed spontaneous disappearance or diminished staining of C1q deposition. These findings suggest that C1q deposition found in renal allografts is most likely clinically benign, although this possibility should be confirmed in further large-scale studies.
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Affiliation(s)
- Eun-Ah Jo
- Department of Surgery, Seoul National University College of Medicine, Seoul, Korea
| | - Hyo Kee Kim
- Department of Surgery, Seoul National University College of Medicine, Seoul, Korea
- Department of Surgery, Korea University Guro Hospital, Seoul, Korea
| | - Sangil Min
- Department of Surgery, Seoul National University College of Medicine, Seoul, Korea
| | - Kyung Chul Moon
- Department of Pathology, Seoul National University College of Medicine, Seoul, Korea
| | - Ahram Han
- Department of Surgery, Seoul National University College of Medicine, Seoul, Korea
| | - Sanghyun Ahn
- Department of Surgery, Seoul National University College of Medicine, Seoul, Korea
| | - Seung-Kee Min
- Department of Surgery, Seoul National University College of Medicine, Seoul, Korea
| | - Jongwon Ha
- Department of Surgery, Seoul National University College of Medicine, Seoul, Korea
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25
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Choi JS, Ko H, Kim HK, Chung C, Han A, Min SK, Ha J, Kang HG, Ha IS, Min S. Effects of tacrolimus intrapatient variability and CYP3A5 polymorphism on the outcomes of pediatric kidney transplantation. Pediatr Transplant 2022; 26:e14297. [PMID: 35466485 DOI: 10.1111/petr.14297] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Revised: 03/16/2022] [Accepted: 04/07/2022] [Indexed: 12/17/2022]
Abstract
BACKGROUND The intrapatient variability (IPV) of tacrolimus (Tac) is associated with the long-term outcome of kidney transplantation. The CYP3A single-nucleotide polymorphism (SNP) may affect the IPV of Tac. We investigated the impact of IPV and genetic polymorphism in pediatric patients who received kidney transplantation. METHODS A total of 202 pediatric renal transplant recipients from 2000 to 2016 were analyzed retrospectively. The IPV was calculated between 6 and 12 months after surgery. Among these patients, CYP3A5 polymorphism was analyzed in 67 patients. RESULTS The group with high IPV had a significantly higher rate of de novo donor-specific human leukocyte antigen antibodies (dnDSA) development (35.7% vs. 16.7%, p = .003). The high IPV group also had a higher incidence of T-cell-mediated rejection (TCMR; p < .001). The high IPV had no significant influence on Epstein-Barr virus, cytomegalovirus, and BK virus viremia but was associated with the incidence of posttransplant lymphoproliferative disorders (p = .003). Overall, the graft survival rate was inferior in the high IPV group (p < .001). The CYP3A5 SNPs did not significantly affect the IPV of Tac. In the CYP3A5 expressor group, however, the IPV was significantly associated with the TCMR-free survival rate (p < .001). CONCLUSION The IPV of Tac had a significant impact on dnDSA development, occurrence of acute TCMR, and graft failure in pediatric patients who received renal transplantation. CYP3A5 expressors with high IPV of Tac showed worse outcomes, while the CYP3A5 polymorphism had no impact on IPV of Tac.
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Affiliation(s)
- Jin Sun Choi
- Department of Surgery, Seoul National University College of Medicine, Seoul, Korea
| | - Hyunmin Ko
- Department of Surgery, Seoul National University College of Medicine, Seoul, Korea
| | - Hyo Kee Kim
- Department of Surgery, Seoul National University College of Medicine, Seoul, Korea
| | - Chris Chung
- Department of Surgery, Seoul National University College of Medicine, Seoul, Korea
| | - Ahram Han
- Department of Surgery, Seoul National University College of Medicine, Seoul, Korea
| | - Seung-Kee Min
- Department of Surgery, Seoul National University College of Medicine, Seoul, Korea
| | - Jongwon Ha
- Department of Surgery, Seoul National University College of Medicine, Seoul, Korea.,Transplantation Research Institute, Seoul National University College of Medicine, Seoul, Korea
| | - Hee Gyung Kang
- Department of Pediatrics, Seoul National University College of Medicine, Seoul, Korea
| | - Il Soo Ha
- Department of Pediatrics, Seoul National University College of Medicine, Seoul, Korea
| | - Sangil Min
- Department of Surgery, Seoul National University College of Medicine, Seoul, Korea
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26
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Ha J, Kim J, Jeong C, Lim Y, Kim MK, Kwon HS, Song KH, Kang MI, Baek KH. Effect of follow-up raloxifene therapy after denosumab discontinuation in postmenopausal women. Osteoporos Int 2022; 33:1591-1599. [PMID: 35376989 PMCID: PMC8978765 DOI: 10.1007/s00198-022-06388-w] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Accepted: 03/25/2022] [Indexed: 12/31/2022]
Abstract
UNLABELLED Follow-up raloxifene therapy after denosumab discontinuation resulted in a decrease in bone mass to the pre-denosumab levels and a rebound increase of bone turnover markers. The decrease in lumbar bone mineral density was particularly evident when the body mass index was low, there were previous vertebral fractures, or lumbar bone mineral density before denosumab administration was low. INTRODUCTION Selective estrogen receptor modulators may be an alternative to bisphosphonates for treating rebound resorption after discontinuing denosumab. This study aimed to investigate the effects of follow-up raloxifene therapy after denosumab discontinuation in postmenopausal women. METHODS This retrospective observational study included 61 patients who received 12-month follow-up raloxifene therapy after denosumab discontinuation. The primary endpoint was the bone mineral density change. The secondary endpoints were the changes in bone turnover markers and the incidence of new vertebral fractures. RESULTS Raloxifene administration for 12 months after denosumab discontinuation resulted in a significantly lower bone mineral density at all sites compared to the level at 6 months after the last denosumab treatment (lumbar spine, - 5.48%; femoral neck, - 2.95%; total hip, - 3.52%; all, p < 0.001). The decrease in lumbar bone mineral density was particularly evident when the body mass index was low, there were previous vertebral fractures, or lumbar bone mineral density before denosumab administration was low. Marked increases in the bone turnover markers from baseline were noted after switching to raloxifene. However, no new vertebral fractures occurred during raloxifene treatment. CONCLUSIONS Follow-up raloxifene therapy after denosumab discontinuation resulted in a decrease in bone mass to the pre-denosumab levels and a rebound increase of bone turnover markers. Therefore, raloxifene administered sequentially after denosumab discontinuation was not effective in preventing rebound phenomenon.
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Affiliation(s)
- J Ha
- Department of Internal Medicine, Division of Endocrinology and Metabolism, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - J Kim
- Department of Internal Medicine, Division of Endocrinology and Metabolism, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - C Jeong
- Department of Internal Medicine, Division of Endocrinology and Metabolism, Uijeongbu St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Uijeongbu, Republic of Korea
| | - Y Lim
- Department of Internal Medicine, Division of General Internal Medicine, National University Bundang Hospital, Seongnam, Republic of Korea
| | - M K Kim
- Department of Internal Medicine, Division of Endocrinology and Metabolism, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - H-S Kwon
- Department of Internal Medicine, Division of Endocrinology and Metabolism, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - K-H Song
- Department of Internal Medicine, Division of Endocrinology and Metabolism, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - M I Kang
- Department of Internal Medicine, Division of Endocrinology and Metabolism, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - K-H Baek
- Department of Internal Medicine, Division of Endocrinology and Metabolism, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
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27
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Park S, Yang SH, Kim J, Cho S, Yang J, Min SI, Ha J, Jeong CW, Bhoo SH, Kim YC, Kim DK, Oh KH, Joo KW, Kim YS, Moon KC, Song EY, Lee H. Clinical Significances of Anti-Collagen Type I and Type III Antibodies in Antibody-Mediated Rejection. Transpl Int 2022; 35:10099. [PMID: 35634584 PMCID: PMC9131656 DOI: 10.3389/ti.2022.10099] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Accepted: 04/13/2022] [Indexed: 12/02/2022]
Abstract
It is important to determine the clinical significance of non-human leukocyte antigen (HLA) antibodies and their association with antibody-mediated rejection (ABMR) of kidney allografts. We collected post-transplant sera from 68 ABMR patients, 67 T-cell mediated rejection (TCMR) patients, and 83 control subjects without rejection, and determined the titers of 39 non-HLA antibodies including antibodies for angiotensin II receptor type I and MICA. We compared all these non-HLA antibody titers among the study groups. Then, we investigated their association with the risk of death-censored graft failure in ABMR cases. Among the antibodies evaluated, anti-collagen type I (p = 0.001) and type III (p < 0.001) antibody titers were significantly higher in ABMR cases than in both TCMR cases and no-rejection controls. Both anti-collagen type I [per 1 standard deviation (SD), adjusted odds ratio (OR), 11.72 (2.73-76.30)] and type III [per 1 SD, adjusted OR, 6.22 (1.91-31.75)] antibodies were significantly associated with the presence of ABMR. Among ABMR cases, a higher level of anti-collagen type I [per 1 SD, adjusted hazard ratio (HR), 1.90 (1.32-2.75)] or type III per 1 SD, [adjusted HR, 1.57 (1.15-2.16)] antibody was associated with a higher risk of death-censored graft failure. In conclusion, post-transplant anti-collagen type I and type III antibodies may be novel non-HLA antibodies related to ABMR of kidney allografts.
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Affiliation(s)
- Sehoon Park
- Department of Internal Medicine, Armed Forces Capital Hospital, Seongnam-si, South Korea,Department of Biomedical Sciences, Seoul National University College of Medicine, Seoul, South Korea
| | - Seung-Hee Yang
- Kidney Research Institute, Seoul National University, Seoul, South Korea
| | - Jiyeon Kim
- Kidney Research Institute, Seoul National University, Seoul, South Korea
| | - Semin Cho
- Department of Internal Medicine, Seoul National University Hospital, Seoul, South Korea
| | - Jaeseok Yang
- Transplantation Center, Department of Surgery, Seoul National University Hospital, Seoul, South Korea
| | - Sang-Il Min
- Transplantation Center, Department of Surgery, Seoul National University Hospital, Seoul, South Korea,Department of Surgery, Seoul National University College of Medicine, Seoul, South Korea
| | - Jongwon Ha
- Transplantation Center, Department of Surgery, Seoul National University Hospital, Seoul, South Korea,Department of Surgery, Seoul National University College of Medicine, Seoul, South Korea
| | - Chang Wook Jeong
- Department of Urology, Seoul National University Hospital, Seoul, South Korea
| | - Seong Hee Bhoo
- Department of Genetic Engineering and Graduate School of Biotechnology, Kyung Hee University, Yongin-si, South Korea
| | - Yong Chul Kim
- Department of Internal Medicine, Seoul National University Hospital, Seoul, South Korea,Deparment of Internal Medicine, Seoul National University College of Medicine, Seoul, South Korea
| | - Dong Ki Kim
- Kidney Research Institute, Seoul National University, Seoul, South Korea,Department of Internal Medicine, Seoul National University Hospital, Seoul, South Korea,Deparment of Internal Medicine, Seoul National University College of Medicine, Seoul, South Korea
| | - Kook-Hwan Oh
- Department of Internal Medicine, Seoul National University Hospital, Seoul, South Korea,Deparment of Internal Medicine, Seoul National University College of Medicine, Seoul, South Korea
| | - Kwon Wook Joo
- Kidney Research Institute, Seoul National University, Seoul, South Korea,Department of Internal Medicine, Seoul National University Hospital, Seoul, South Korea,Deparment of Internal Medicine, Seoul National University College of Medicine, Seoul, South Korea
| | - Yon Su Kim
- Kidney Research Institute, Seoul National University, Seoul, South Korea,Department of Internal Medicine, Seoul National University Hospital, Seoul, South Korea,Deparment of Internal Medicine, Seoul National University College of Medicine, Seoul, South Korea
| | - Kyung Chul Moon
- Department of Pathology, Seoul National University Hospital, Seoul, South Korea
| | - Eun Young Song
- Department of Laboratory Medicine, Seoul National University Hospital, Seoul, South Korea,*Correspondence: Eun Young Song, , orcid.org/0000-0003-1286-9611; Hajeong Lee, , orcid.org/0000-0002-1873-1587
| | - Hajeong Lee
- Department of Internal Medicine, Seoul National University Hospital, Seoul, South Korea,Deparment of Internal Medicine, Seoul National University College of Medicine, Seoul, South Korea,*Correspondence: Eun Young Song, , orcid.org/0000-0003-1286-9611; Hajeong Lee, , orcid.org/0000-0002-1873-1587
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28
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Park J, Kang M, Ha J, Lee H. Fulminant hepatitis and myocarditis associated with varicella zoster virus infection in a kidney transplant recipient: a case report. Korean J Transplant 2022; 36:221-225. [PMID: 36275991 PMCID: PMC9574427 DOI: 10.4285/kjt.22.0009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Revised: 03/21/2022] [Accepted: 03/24/2022] [Indexed: 11/29/2022] Open
Abstract
Varicella zoster virus (VZV) infection can follow a virulent course, leading to possible infection-related mortality in immunocompromised hosts. Visceral disseminated VZV infection is a rare disease with a high mortality rate in immunocompromised patients. We present a case of acute liver failure and acute myocarditis due to visceral disseminated VZV infection in an immunocompromised patient who had recently received kidney transplantation and who subsequently showed dramatic improvement after treatment with intravenous acyclovir and intravenous immunoglobulin. Severe epigastric pain preceded the vesicular skin lesions; therefore, the diagnosis and treatment could have been delayed. Such delays have caused mortality in most previous cases. Therefore, it is necessary to consider visceral disseminated viral infection in the differential diagnosis of immunocompromised patients when multi-organ failure progresses with an unknown cause.
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Affiliation(s)
- Jeayeon Park
- Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea
| | - Minjung Kang
- Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea
| | - Jongwon Ha
- Department of Surgery, Seoul National University Hospital, Seoul, Korea
| | - Hajeong Lee
- Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea
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29
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Ha J, Baek KH. Correction to: Response to letter, re. "Comparison of fracture risk between type 1 and type 2 diabetes: a comprehensive real-world data". Osteoporos Int 2022; 33:957. [PMID: 35275220 DOI: 10.1007/s00198-022-06373-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- J Ha
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - K-H Baek
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
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30
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Ahn S, Jo EA, Mo H, Jung IM, Kim HK, Han A, Min S, Min SK, Ha J. The True Incidence of Ruptured Abdominal Aortic Aneurysm: 20-Year Multicenter Review. J Vasc Surg 2022. [DOI: 10.1016/j.jvs.2022.01.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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31
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Ha J, Baek KH. Response to letter, re. "Comparison of fracture risk between type 1 and type 2 diabetes: a comprehensive real-world data". Osteoporos Int 2022; 33:955-956. [PMID: 35175393 DOI: 10.1007/s00198-022-06336-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Accepted: 02/07/2022] [Indexed: 11/24/2022]
Affiliation(s)
- J Ha
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - K-H Baek
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
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32
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Jang Y, Park S, Lee H, Kim YH, Lee JP, Park SK, Jung IM, Ha J, Lim CS, Kim YS, Kwon H, Kim YC. Prognostic Value of Pre- and Post-Serum Alkaline Phosphatase Among Renal Transplant Recipients. Transplant Proc 2022; 54:678-684. [DOI: 10.1016/j.transproceed.2022.02.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Accepted: 02/01/2022] [Indexed: 12/01/2022]
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33
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Kim SM, Lim Y, Min S, Min BJ, Seo ME, Lee KH, Kim JH, Ha J. Flat Pattern Peaks of Tacrolimus Absorption and Associated Pharmacogenomic Variants in Kidney Transplantation Recipients. J Korean Med Sci 2022; 37:e33. [PMID: 35132839 PMCID: PMC8822115 DOI: 10.3346/jkms.2022.37.e33] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Accepted: 12/15/2021] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND Tacrolimus is the most commonly used immunosuppressive drug in solid organ transplantation. After administering a conventional twice-daily dose of tacrolimus, peak levels were achieved within the first 1.5 to 2 hours. A group of patients showed different early absorption phase of tacrolimus after kidney transplantation. METHODS Trough(C0) and 1.5-hour blood levels (C1.5) of tacrolimus were measured in 95 kidney transplantation recipients. Patients with a C1.5/C0 < 1.5 and > 1.5 were defined as those having flat pattern peaks and as controls, respectively. Transplantation outcomes were compared between the groups. Whole exome sequencing was performed to investigate the genetic susceptibility to flat pattern peaks. RESULTS Twenty-eight patients showed flat pattern peaks. The mean C1.5/C0 values were 1.13 ± 0.22 and 3.78 ± 1.25 in the flat pattern peak and control groups, respectively. In multivariate analysis, flat pattern peak was an independent risk factor for biopsy-proven acute rejection (BPAR) and/or borderline change (P = 0.014). Patients having flat pattern peaks showed significantly lower post-transplant 36-month estimated glomerular filtration rate (P = 0.001). Two single nucleotide variants in ABCB1 genes, rs1922242 and rs2235035, were associated with flat pattern peaks (P = 0.019 and P = 0.027, respectively). CONCLUSION Both of C1.5 and C0 should be measured to distinguish the patients showing unique initial absorption. A C1.5/C0 ratio lower than 1.5 was associated with an increased risk of BPAR and/or borderline change. Single nucleotide variants s in ABCB1 gene might influence the flat pattern peaks of tacrolimus absorption.
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Affiliation(s)
- Suh Min Kim
- Department of Surgery, Chung-Ang University College of Medicine, Seoul, Korea
| | - Younggyun Lim
- Seoul National University Biomedical Informatics (SNUBI), Division of Biomedical Informatics, Seoul National University College of Medicine, Seoul, Korea
| | - Sangil Min
- Department of Surgery, Seoul National University College of Medicine, Seoul, Korea
| | - Byung-Joo Min
- Seoul National University Biomedical Informatics (SNUBI), Division of Biomedical Informatics, Seoul National University College of Medicine, Seoul, Korea
| | - Myung-Eui Seo
- Seoul National University Biomedical Informatics (SNUBI), Division of Biomedical Informatics, Seoul National University College of Medicine, Seoul, Korea
| | - Kye Hwa Lee
- Department of Information Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Ju Han Kim
- Seoul National University Biomedical Informatics (SNUBI), Division of Biomedical Informatics, Seoul National University College of Medicine, Seoul, Korea.
| | - Jongwon Ha
- Department of Surgery, Seoul National University College of Medicine, Seoul, Korea
- Transplantation Research Institute, Seoul National University College of Medicine, Seoul, Korea.
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34
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Mo H, Lee J, Park JB, Park SC, Kim YH, Han A, Jung IM, Ha J, Kim NJ, Min S. Kidney Transplantation From Deceased Donors With Bloodstream Infection: A Multicenter Retrospective Study. J Korean Med Sci 2022; 37:e4. [PMID: 34981680 PMCID: PMC8723893 DOI: 10.3346/jkms.2022.37.e4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Accepted: 11/11/2021] [Indexed: 01/16/2023] Open
Abstract
BACKGROUND The use of organs from donors with infection is limited because of the possibility of transmission. We aimed to investigate the transmission after deceased donor transplantation with bloodstream infection (BSI). METHODS A retrospective study of patients undergoing kidney or pancreas transplantation at five tertiary centers in Korea from January 2009 and November 2019 was performed. We analyzed the outcomes after transplantation from deceased donors with BSI. RESULTS Eighty-six recipients received transplantation from 69 donors with BSI. The most common isolated pathogens from donors were Gram-positive bacteria (72.0%), followed by Gram-negative bacteria (22.7%), and fungi (5.3%). Appropriate antimicrobial agents were used in 47.8% of donors before transplantation. Transmission occurred only in 1 of 83 recipients (1.2%) from bacteremic donors and 1 of 6 recipients (16.7%) from fungemic donors. One-year patient and graft survival was 97.5%and 96.3%, respectively. There was no significant difference in graft and patient survival between patients who received organs from infected donors and noninfected donors. CONCLUSION Using organs from donors with bacteremia seems to be a safe option with low transmission risk. The overall prognosis of using organs from donors with BSI is favorable.
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Affiliation(s)
- Hyejin Mo
- Department of Surgery, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul, Korea
| | - Juhan Lee
- Department of Surgery, Yonsei University College of Medicine, Seoul, Korea
| | - Jae Berm Park
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Sun Cheol Park
- Department of Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Young Hoon Kim
- Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Ahram Han
- Department of Surgery, Seoul National University College of Medicine, Seoul, Korea
| | - In Mok Jung
- Department of Surgery, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul, Korea
| | - Jongwon Ha
- Department of Surgery, Seoul National University College of Medicine, Seoul, Korea
- Transplantation Research Institute, Seoul National University College of Medicine, Seoul, Korea
| | - Nam-Joong Kim
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Sangil Min
- Department of Surgery, Seoul National University College of Medicine, Seoul, Korea.
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35
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Ha J, Jeong C, Han KD, Lim Y, Kim MK, Kwon HS, Song KH, Kang MI, Baek KH. Comparison of fracture risk between type 1 and type 2 diabetes: a comprehensive real-world data. Osteoporos Int 2021; 32:2543-2553. [PMID: 34333678 DOI: 10.1007/s00198-021-06032-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Accepted: 06/11/2021] [Indexed: 12/24/2022]
Abstract
UNLABELLED Population-based cohort study of 6,548,784 Korean subjects demonstrates that the risk of fracture was higher in patients with diabetes than in nondiabetic subjects. Furthermore, patients with type 1 diabetes were associated with a higher risk of fracture than patients with type 2 diabetes for all measurement sites. INTRODUCTION Diabetes mellitus is associated with increased fracture risk. Although the pathophysiologic effect on bone metabolism differs according to the type of diabetes, a higher risk of fracture in patients with diabetes than in nondiabetic patients has been consistently demonstrated. Considering the ever-increasing number of patients with diabetes, we aimed to provide updated information on whether this phenomenon remains valid in real-world settings by using large-scale population datasets. METHODS We conducted a retrospective longitudinal study using data from the Korean National Health Insurance Service dataset of preventive health check-ups between January 2009 and December 2016. The hazard ratios were calculated for any fracture, vertebral fracture, and hip fracture and were analyzed according to the presence and type of diabetes. Among 10,585,818 subjects, 6,548,784 were eligible for the analysis (2418 patients with type 1 diabetes mellitus [T1DM] and 506,208 patients with type 2 diabetes mellitus [T2DM]). RESULTS The mean follow-up duration (in years) was 7.0 ± 1.3 for subjects without diabetes, 6.4 ± 2.0 for those with T1DM, and 6.7 ± 1.7 for T2DM. Patients with T1DM had a higher incidence rate for all types of fractures per 1000 person-years. The fully adjusted hazard ratios (HRs) for any fracture, vertebral fracture, and hip fracture were higher in T1DM than in T2DM (1.37 [95% confidence interval (CI): 1.23-1.52] for any fracture, 1.33 [95% CI: 1.09-1.63] for vertebral fracture, and 1.99 [95% CI: 1.56-2.53] for hip fracture). CONCLUSIONS In this large-scale population analysis, diabetes was associated with a higher risk of all types of fractures. Patients with T1DM had a higher risk of fracture than those with T2DM for all measurement sites, and hip fractures had the highest risk. Therefore, fracture prevention training for patients with diabetes is advisable.
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Affiliation(s)
- J Ha
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - C Jeong
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - K-D Han
- Department of Statistics and Actuarial Science, Soongsil University, Seoul, Republic of Korea
| | - Y Lim
- Division of General Internal Medicine, Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - M K Kim
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - H-S Kwon
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - K-H Song
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - M I Kang
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - K-H Baek
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
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Park E, Ha J, Lim S, Kim G, Yoon Y. Development of postbiotics by whey bioconversion with Enterococcus faecalis M157 KACC81148BP and Lactococcus lactis CAU2013 KACC81152BP for treating periodontal disease and improving gut health. J Dairy Sci 2021; 104:12321-12331. [PMID: 34600708 DOI: 10.3168/jds.2021-20616] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Accepted: 08/18/2021] [Indexed: 12/15/2022]
Abstract
This study developed postbiotics with whey bioconversion product produced by Enterococcus faecalis M157 KACC 81148BP, and mixed whey bioconversion products produced by E. faecalis M157 KACC 81148BP and Lactococcus lactis ssp. lactis CAU2013 KACC 81152BP to alleviate periodontitis (PD) and to improve gut health. The powdered whey bioconversion product (EF) produced by E. faecalis M157 KACC 81148BP, mixed whey bioconversion products (EF+LL) from E. faecalis M157 KACC 81148BP and L. lactis CAU2013 KACC 81152BP, and phosphate-buffered saline (PBS; control) were administered orally to PD-induced rats for 8 wk. Infiltration of inflammatory cells and epithelial proliferation in periodontal tissue were found in control, but the lesions were reduced in PD+EF group (administration of EF to PD-induced rats), and no lesions were observed in PD+EF+LL group (administration of EF+LL to PD-induced rats). The bone loss volumes in PD+EF and PD+EF+LL groups were lower than in control. Cytokine production levels related to inflammation were lower and antioxidative stress markers were higher in PD+EF and PD+EF+LL groups than in control for both periodontal tissue and gut. The ratios of Lactobacillus spp. in gut microbiome of PD+EF and PD+EF+LL groups were higher than in control. These results indicate that the whey bioconversion product produced by E. faecalis M157 KACC 81148BP, and mixed whey bioconversion products produced by E. faecalis M157 KACC 81148BP and L. lactis CAU2013 KACC 81152BP are effective on relieving periodontitis and improving the gut health.
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Affiliation(s)
- E Park
- Department of Food and Nutrition, Sookmyung Women's University, Seoul 04310, Korea
| | - J Ha
- Center for Consumer Health Research, CHA Advanced Research Institute, Seongnam 13488, Korea
| | - S Lim
- Food Standard Research Center, Korea Food Research Institute, Jeollabuk-do 55365, Korea
| | - G Kim
- Department of Animal Science and and Technology, Chung-Ang University, Anseong 17546, Korea
| | - Y Yoon
- Department of Food and Nutrition, Sookmyung Women's University, Seoul 04310, Korea; Risk Analysis Research Center, Sookmyung Women's University, Seoul 04310, Korea.
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Park JW, Curtis JR, Jun KI, Kim TM, Heo DS, Ha J, Suh KS, Lee KW, Lee H, Yang J, Kim MJ, Choi Y, Lee EB. Primary prophylaxis for Pneumocystis jirovecii pneumonia in patients receiving rituximab. Chest 2021; 161:1201-1210. [PMID: 34788668 DOI: 10.1016/j.chest.2021.11.007] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2021] [Revised: 09/07/2021] [Accepted: 11/04/2021] [Indexed: 10/19/2022] Open
Abstract
BACKGROUND Although previous studies suggested that rituximab increases the risk of Pneumocystis jirovecii pneumonia (PJP), it is uncertain whether its primary prophylaxis for PJP is justified. RESEARCH QUESTION Does the benefit of primary prophylaxis for PJP in patients receiving rituximab treatment outweigh the potential risk of the prophylaxis? STUDY DESIGN AND METHODS This retrospective study included 3524 patients (hematologic diseases=2500; rheumatic diseases=559; pre/post-solid organ transplantation=465) first exposed to rituximab between 2002 and 2018 in a tertiary referral center in South Korea. Patients were classified into a control group (n=2523) and a prophylaxis group (n=1001) according to the administration of prophylactic TMP-SMX during the first 28 days after the start of rituximab (intention-to-treat analysis). In addition, exposure to TMP-SMX was examined as a time-varying variable (time-varying analysis). Primary outcome was the prophylactic effect of TMP-SMX on the 1-year incidence of PJP. Inverse probability of treatment weights was applied to minimize the baseline imbalance. Secondary outcome included the incidence of adverse drug reactions (ADRs) related to TMP-SMX. RESULTS Over 2759.9 person-years, 92 PJP infections occurred, with a mortality rate of 27.2%. The prophylaxis group showed a significantly lower incidence of PJP (adjusted sub-distribution hazard ratio (aSHR), 0.20 [95% CI, 0.10-0.42]) than the control group. This result was consistent with the results of time-varying analysis, in which only one PJP infection occurred during TMP-SMX administration (aSHR, 0.01 [0.003-0.16]). The incidence of adverse drug reactions (ADRs) related to TMP-SMX was 18.1 (14.6-22.2)/100 person-years, and most were of mild-to-moderate severity. Based on ten severe ADRs, the number needed to harm was 101 (61.9-261.1), whereas the number needed to prevent one PJP infection was 32 (24.8-39.4). INTERPRETATION TMP-SMX prophylaxis significantly reduces PJP incidence with a tolerable safety profile in patients receiving rituximab treatment.
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Affiliation(s)
- Jun Won Park
- Division of Rheumatology, Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Jeffrey R Curtis
- Division of Clinical Immunology & Rheumatology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Kang Il Jun
- Division of Infectious Disease, Department of Internal Medicine, Ewha Womans University Seoul Hospital, Seoul, Republic of Korea
| | - Tae Min Kim
- Division of Hematology and Medical Oncology, Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea; Cancer Research Institute, Seoul National University, Seoul, Republic of Korea
| | - Dae Seog Heo
- Division of Hematology and Medical Oncology, Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea; Cancer Research Institute, Seoul National University, Seoul, Republic of Korea
| | - Jongwon Ha
- Department of Surgery, Seoul National University College of Medicine, Seoul, Republic of Korea; Transplantation Research Institute, Medical Research Center, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Kyung-Suk Suh
- Department of Surgery, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Kwang-Woong Lee
- Department of Surgery, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Hajeong Lee
- Division of Nephrology, Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Jaeseok Yang
- Transplantation Center, Seoul National University Hospital, Seoul, Republic of Korea
| | - Min Jung Kim
- Division of Medical Statistics, Medical Research Collaborating Center, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Yunhee Choi
- Division of Medical Statistics, Medical Research Collaborating Center, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Eun Bong Lee
- Division of Rheumatology, Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea; Department of Molecular Medicine and Biopharmaceutical Sciences, Graduate School of Convergence Science and Technology, Seoul National University, Seoul, Republic of Korea.
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Han A, Park T, Kim H, Min S, Ha J, Min SK. Paclitaxel Coated Balloon Angioplasty vs. Plain Balloon Angioplasty for Haemodialysis Arteriovenous Access Stenosis: A Systematic Review and a Time to Event Meta-Analysis of Randomised Controlled Trials. J Vasc Surg 2021. [DOI: 10.1016/j.jvs.2021.09.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Kim JM, Hong SH, Shin JS, Min BH, Kim HJ, Chung H, Kim J, Bang YJ, Seo S, Hwang ES, Kang HJ, Ha J, Park CG. Long-term control of diabetes in a nonhuman primate by two separate transplantations of porcine adult islets under immunosuppression. Am J Transplant 2021; 21:3561-3572. [PMID: 34058060 DOI: 10.1111/ajt.16704] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Revised: 04/29/2021] [Accepted: 05/24/2021] [Indexed: 01/25/2023]
Abstract
Porcine islet transplantation is an alternative to allo-islet transplantation. Retransplantation of islets is a routine clinical practice in islet allotransplantation in immunosuppressed recipients and will most likely be required in islet xenotransplantation in immunosuppressed recipients. We examined whether a second infusion of porcine islets could restore normoglycemia and further evaluated the efficacy of a clinically available immunosuppression regimen including anti-thymocyte globulin for induction; belimumab, sirolimus, and tofacitinib for maintenance and adalimumab, anakinra, IVIg, and tocilizumab for inflammation control in a pig to nonhuman primate transplantation setting. Of note, all nonhuman primates were normoglycemic after the retransplantation of porcine islets without induction therapy. Graft survival was >100 days for all 3 recipients, and 1 of the 3 monkeys showed insulin independence for >237 days. Serious lymphodepletion was not observed, and rhesus cytomegalovirus reactivation was controlled without any serious adverse effects throughout the observation period in all recipients. These results support the clinical applicability of additional infusions of porcine islets. The maintenance immunosuppression regimen we used could protect the reinfused islets from acute rejection.
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Affiliation(s)
- Jong-Min Kim
- Xenotransplantation Research Center, Seoul National University, College of Medicine, Seoul, Korea.,Department of Microbiology and Immunology, Seoul National University, College of Medicine, Seoul, Korea.,Institute of Endemic Diseases, Seoul National University, College of Medicine, Seoul, Korea.,Cancer Research Institute, Seoul National University, College of Medicine, Seoul, Korea
| | - So-Hee Hong
- Xenotransplantation Research Center, Seoul National University, College of Medicine, Seoul, Korea.,Department of Microbiology and Immunology, Seoul National University, College of Medicine, Seoul, Korea.,Institute of Endemic Diseases, Seoul National University, College of Medicine, Seoul, Korea.,Department of Biomedical Sciences, Seoul National University, College of Medicine, Seoul, Korea
| | - Jun-Seop Shin
- Xenotransplantation Research Center, Seoul National University, College of Medicine, Seoul, Korea.,Institute of Endemic Diseases, Seoul National University, College of Medicine, Seoul, Korea.,Cancer Research Institute, Seoul National University, College of Medicine, Seoul, Korea
| | - Byoung-Hoon Min
- Xenotransplantation Research Center, Seoul National University, College of Medicine, Seoul, Korea.,Institute of Endemic Diseases, Seoul National University, College of Medicine, Seoul, Korea.,Cancer Research Institute, Seoul National University, College of Medicine, Seoul, Korea
| | - Hyun Je Kim
- Xenotransplantation Research Center, Seoul National University, College of Medicine, Seoul, Korea.,Department of Microbiology and Immunology, Seoul National University, College of Medicine, Seoul, Korea.,Cancer Research Institute, Seoul National University, College of Medicine, Seoul, Korea.,Department of Biomedical Sciences, Seoul National University, College of Medicine, Seoul, Korea.,Department of Dermatology, Samsung Medical Center, Seoul, Korea
| | - Hyunwoo Chung
- Xenotransplantation Research Center, Seoul National University, College of Medicine, Seoul, Korea.,Department of Microbiology and Immunology, Seoul National University, College of Medicine, Seoul, Korea.,Department of Biomedical Sciences, Seoul National University, College of Medicine, Seoul, Korea
| | - Jiyeon Kim
- Department of Microbiology and Immunology, Seoul National University, College of Medicine, Seoul, Korea.,Institute of Endemic Diseases, Seoul National University, College of Medicine, Seoul, Korea
| | - Yoon Ji Bang
- Department of Microbiology and Immunology, Seoul National University, College of Medicine, Seoul, Korea.,Department of Biomedical Sciences, Seoul National University, College of Medicine, Seoul, Korea
| | - Sol Seo
- Department of Microbiology and Immunology, Seoul National University, College of Medicine, Seoul, Korea.,Department of Biomedical Sciences, Seoul National University, College of Medicine, Seoul, Korea
| | - Eung Soo Hwang
- Xenotransplantation Research Center, Seoul National University, College of Medicine, Seoul, Korea.,Department of Microbiology and Immunology, Seoul National University, College of Medicine, Seoul, Korea.,Institute of Endemic Diseases, Seoul National University, College of Medicine, Seoul, Korea
| | - Hee-Jung Kang
- Xenotransplantation Research Center, Seoul National University, College of Medicine, Seoul, Korea.,Department of Laboratory Medicine, Hallym University College of Medicine, Anyang, Korea
| | - Jongwon Ha
- Department of Surgery, Seoul National University College of Medicine, Seoul, Korea
| | - Chung-Gyu Park
- Xenotransplantation Research Center, Seoul National University, College of Medicine, Seoul, Korea.,Department of Microbiology and Immunology, Seoul National University, College of Medicine, Seoul, Korea.,Institute of Endemic Diseases, Seoul National University, College of Medicine, Seoul, Korea.,Cancer Research Institute, Seoul National University, College of Medicine, Seoul, Korea.,Department of Biomedical Sciences, Seoul National University, College of Medicine, Seoul, Korea
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40
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Choi KW, Min S, Jo EA, Han A, Ahn S, Min SK, Ha J. ABO-incompatibility and donor-specific antibodies existence effect on antibody-mediated rejection in kidney transplantation. Korean Journal of Transplantation 2021. [DOI: 10.4285/atw2021.op-1066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Affiliation(s)
- Kwang Woo Choi
- Department of Surgery-Transplantation, Seoul National University Hospital, Seoul, Korea
| | - Sangil Min
- Department of Surgery-Transplantation, Seoul National University Hospital, Seoul, Korea
| | - Eun-Ah Jo
- Department of Surgery-Transplantation, Seoul National University Hospital, Seoul, Korea
| | - Ahram Han
- Department of Surgery-Transplantation, Seoul National University Hospital, Seoul, Korea
| | - Sanghyun Ahn
- Department of Surgery-Transplantation, Seoul National University Hospital, Seoul, Korea
| | - Seung-Kee Min
- Department of Surgery-Transplantation, Seoul National University Hospital, Seoul, Korea
| | - Jongwon Ha
- Department of Surgery-Transplantation, Seoul National University Hospital, Seoul, Korea
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41
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Han A, Jo EA, Choi K, Min S, Ha J. Clinical significance of chronic active T-cell-mediated rejection. Korean Journal of Transplantation 2021. [DOI: 10.4285/atw2021.or-1294] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Affiliation(s)
- Ahram Han
- Department of Surgery-Transplantation, Seoul National University College of Medicine, Seoul, Korea
| | - Eun-Ah Jo
- Department of Surgery-Transplantation, Seoul National University College of Medicine, Seoul, Korea
| | - Kwangwoo Choi
- Department of Surgery-Transplantation, Seoul National University College of Medicine, Seoul, Korea
| | - Sangil Min
- Department of Surgery-Transplantation, Seoul National University College of Medicine, Seoul, Korea
| | - Jongwon Ha
- Department of Surgery-Transplantation, Seoul National University College of Medicine, Seoul, Korea
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42
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Han A, Kim HK, Ahn S, Min SK, Kim S, Jeong C, Park H, Min S, Ha J. Immunomodulatory effects of probiotic Bifidobacterium bifidum with tacrolimus and sirolimus in mouse skin graft model. Korean Journal of Transplantation 2021. [DOI: 10.4285/atw2021.or-1175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Affiliation(s)
- Ahram Han
- Department of Surgery-Transplantation, Seoul National University College of Medicine, Seoul, Korea
| | - Hyo Kee Kim
- Department of Surgery, Korea University Guro Hospital, Seoul, Korea
| | - Sanghyun Ahn
- Department of Surgery-Transplantation, Seoul National University College of Medicine, Seoul, Korea
| | - Seung-Kee Min
- Department of Surgery-Transplantation, Seoul National University College of Medicine, Seoul, Korea
| | - Sujeong Kim
- Department of Biomedical Science and Engineering, Gwangju Institute of Science and Technology, Gwangju, Korea
| | - Chanyeong Jeong
- Department of Biomedical Science and Engineering, Gwangju Institute of Science and Technology, Gwangju, Korea
| | - Hansoo Park
- Department of Biomedical Science and Engineering, Gwangju Institute of Science and Technology, Gwangju, Korea
| | - Sangil Min
- Department of Surgery-Transplantation, Seoul National University College of Medicine, Seoul, Korea
| | - Jongwon Ha
- Department of Surgery-Transplantation, Seoul National University College of Medicine, Seoul, Korea
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43
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Song J, Jeong S, Min S, Ha J, Kim YS, Lee JP, Jeong JC, Lee H. Clinical significance of delayed or slow graft function in kidney transplantation recipients. Korean Journal of Transplantation 2021. [DOI: 10.4285/atw2021.op-1290] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Affiliation(s)
- Jeongin Song
- Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea
| | - Sehyun Jeong
- Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea
| | - Sangil Min
- Department of Surgery, Seoul National University Hospital, Seoul, Korea
| | - Jongwon Ha
- Department of Surgery, Seoul National University Hospital, Seoul, Korea
| | - Yon Su Kim
- Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea
| | - Jeong Pyo Lee
- Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea
| | - Jong Cheol Jeong
- Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea
| | - Hajeong Lee
- Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea
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44
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Yoon JG, Song SH, Choi S, Oh J, Jang IJ, Kim YJ, Moon S, Kim BJ, Cho Y, Kim HK, Min S, Ha J, Shin HS, Yang CW, Yoon HE, Yang J, Lee MG, Park JB, Kim MS. Unraveling the Genomic Architecture of the CYP3A Locus and ADME Genes for Personalized Tacrolimus Dosing. Transplantation 2021; 105:2213-2225. [PMID: 33654003 DOI: 10.1097/tp.0000000000003660] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Tacrolimus (TAC) is an immunosuppressant widely prescribed following an allogenic organ transplant. Due to wide interindividual pharmacokinetic (PK) variability, optimizing TAC dosing based on genetic factors is required to minimize nephrotoxicity and acute rejections. METHODS We enrolled 1133 participants receiving TAC from 4 cohorts, consisting of 3 with kidney transplant recipients and 1 with healthy males from clinical trials. The effects of clinical factors were estimated to appropriately control confounding variables. A genome-wide association study, haplotype analysis, and a gene-based association test were conducted using the Korea Biobank Array or targeted sequencing for 114 pharmacogenes. RESULTS Genome-wide association study verified that CYP3A5*3 is the only common variant associated with TAC PK variability in Koreans. We detected several CYP3A5 and CYP3A4 rare variants that could potentially affect TAC metabolism. The haplotype structure of CYP3A5 stratified by CYP3A5*3 was a significant factor for CYP3A5 rare variant interpretation. CYP3A4 rare variant carriers among CYP3A5 intermediate metabolizers displayed higher TAC trough levels. Gene-based association tests in the 61 absorption, distribution, metabolism, and excretion genes revealed that CYP1A1 are associated with additional TAC PK variability: CYP1A1 rare variant carriers among CYP3A5 poor metabolizers showed lower TAC trough levels than the noncarrier controls. CONCLUSIONS Our study demonstrates that rare variant profiling of CYP3A5 and CYP3A4, combined with the haplotype structures of CYP3A locus, provide additive value for personalized TAC dosing. We also identified a novel association between CYP1A1 rare variants and TAC PK variability in the CYP3A5 nonexpressers that needs to be further investigated.
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Affiliation(s)
- Jihoon G Yoon
- Department of Pharmacology, Yonsei University College of Medicine, Seoul, Republic of Korea
- Brain Korea 21 PLUS Project for Medical Sciences, Severance Biomedical Science Institute, Seoul, Republic of Korea
| | - Seung Hwan Song
- Department of Surgery, Yonsei University College of Medicine, Seoul, Republic of Korea
- Department of Surgery, Ewha Womans University Seoul Hospital, Seoul, Republic of Korea
| | - Sungkyoung Choi
- Department of Applied Mathematics, Hanyang University (ERICA), Ansan, Republic of Korea
| | - Jaeseong Oh
- Department of Clinical Pharmacology and Therapeutics, Seoul National University College of Medicine and Hospital, Seoul, Republic of Korea
| | - In-Jin Jang
- Department of Clinical Pharmacology and Therapeutics, Seoul National University College of Medicine and Hospital, Seoul, Republic of Korea
| | - Young Jin Kim
- Division of Genome Research, Department of Precision Medicine, National Institute of Health, Chungcheongbuk-do, Republic of Korea
| | - Sanghoon Moon
- Division of Genome Research, Department of Precision Medicine, National Institute of Health, Chungcheongbuk-do, Republic of Korea
| | - Bong-Jo Kim
- Division of Genome Research, Department of Precision Medicine, National Institute of Health, Chungcheongbuk-do, Republic of Korea
| | - Yuri Cho
- Department of Surgery, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Hyo Kee Kim
- Department of Surgery, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Sangil Min
- Department of Surgery, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Jongwon Ha
- Department of Surgery, Seoul National University College of Medicine, Seoul, Republic of Korea
- Transplantation Research Institute, Medical Research Center, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Ho Sik Shin
- Division of Nephrology, Department of Internal Medicine, Gospel Hospital, Kosin University College of Medicine, Busan, Republic of Korea
| | - Chul Woo Yang
- Division of Nephrology, Department of Internal Medicine, Seoul St. Mary's Hospital, Seoul, Republic of Korea
| | - Hye Eun Yoon
- Divison of Nephrology, Department of Internal Medicine, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Incheon, Republic of Korea
| | - Jaeseok Yang
- Department of Surgery, Transplantation Center, Seoul National University Hospital, Seoul, Republic of Korea
| | - Min Goo Lee
- Department of Pharmacology, Yonsei University College of Medicine, Seoul, Republic of Korea
- Brain Korea 21 PLUS Project for Medical Sciences, Severance Biomedical Science Institute, Seoul, Republic of Korea
| | - Jae Berm Park
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Myoung Soo Kim
- Department of Surgery, Yonsei University College of Medicine, Seoul, Republic of Korea
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Ahn C, Lee S, Kim YH, Oh J, Yun IJ, Ahn HJ, Seo SH, Jeong JC, Kim MS, Ha J, Kim SI, Moon IS, Cho WH. Improving self-sufficiency in organ transplantation in Korea. Korean J Transplant 2021; 35:137-142. [PMID: 35769245 PMCID: PMC9235443 DOI: 10.4285/kjt.21.0022] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2021] [Revised: 09/24/2021] [Accepted: 09/24/2021] [Indexed: 11/26/2022] Open
Abstract
After attaining a qualified medical capacity in organ transplantation, Korea has been struggling to increase the number of deceased organ transplants to reach self-sufficiency. As one of these efforts, Korea revised the organ transplantation law in 2010 by adding three articles the mandatory reporting based on the recommendation of the 3rd Global Consultation on Organ Transplantation of Madrid in 2010. Along with the new constitution, considerable efforts have been initiated to upgrade the deceased organ transplantation system while maintaining the virtues of fairness, justice, and transparency. The Korean Society of Transplantation played a critical role in revising the law as well as in establishing organizations such as the Korean Organ Donation Agency (KODA; 2009), the Vitallink (2009), and the Korean Organ Transplantation Registry (KOTRY; 2010). By the activities of these professional organizations, Korea could implement fundamental programs such as mandatory reporting and could develop various education programs for organ donation for students and the general population. As a result, the number of deceased donors increased from 1.08 p.m.p. (2000) to 9.23 p.m.p.(2020). Further efforts are needed to increase the number of organ donor cardholders and family consent rates by well-designed, target-specific education programs to overcome traditional negative cultural barriers toward organ donation. The community atmosphere of honoring and thanking donors and their families should be nurtured by national and regional activities of life-sharing weeks linked with organ donor memorial parks.
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Affiliation(s)
- Curie Ahn
- Division of Nephrology, National Medical Center, Seoul, Korea
- Vitallink, Seoul, Korea
| | - Samuel Lee
- Department of Surgery, KangNam Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea
| | - Yeong Hoon Kim
- Division of Nephrology, Inje University Busan Paik Hospital, Busan, Korea
| | - Jieun Oh
- Department of Internal Medicine, Hallym University Kangnam Sacred Heart Hospital, Seoul, Korea
| | - Ik Jin Yun
- Department of Surgery, Konkuk University Medical Center, Seoul, Korea
| | - Hyung Joon Ahn
- Department of Surgery, Kyung Hee University Medical Center, Seoul, Korea
| | | | - Jong Cheol Jeong
- Division of Nephrology, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Myung Soo Kim
- Department of Surgery, Yonsei University College of Medicine, Seoul, Korea
| | - Jongwon Ha
- Department of Surgery, Transplantation Research Institute, Seoul National University College of Medicine, Seoul, Korea
| | - Soon Il Kim
- Department of Surgery, Yonsei University College of Medicine, Seoul, Korea
| | | | - Won Hyun Cho
- Department of Surgery, Keimyung University School of Medicine, Daegu, Korea
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Han A, Park T, Kim HJ, Min S, Ha J, Min SK. Editor's Choice - Paclitaxel Coated Balloon Angioplasty vs. Plain Balloon Angioplasty for Haemodialysis Arteriovenous Access Stenosis: A Systematic Review and a Time to Event Meta-Analysis of Randomised Controlled Trials. Eur J Vasc Endovasc Surg 2021; 62:597-609. [PMID: 34420890 DOI: 10.1016/j.ejvs.2021.05.043] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2020] [Revised: 05/18/2021] [Accepted: 05/30/2021] [Indexed: 12/11/2022]
Abstract
OBJECTIVE A systematic review and meta-analysis of randomised controlled trials (RCTs) was performed to determine the effectiveness and safety of drug coated balloon (DCB) angioplasty compared with uncoated plain balloon (PB) angioplasty in treating arteriovenous access stenosis. METHODS MEDLINE, Embase, Scopus, and the Cochrane Central Register of Controlled Trials were searched for RCTs comparing paclitaxel coated DCB and PB angioplasty for arteriovenous access stenosis. The last date of the literature search was 31 December 2020. Risk of bias of the retrieved studies was assessed with the Cochrane Collaboration tool for assessing risk of bias (RoB 2.0). The random effects model was used to estimate the risk of loss of target lesion patency (six and 12 months) and circuit patency (six and 12 months). Procedure related adverse events and mortality rate were also compared. Patency results were pooled using the time to event meta-analytical method and the quality of evidence was assessed according to the GRADE approach. RESULTS Sixteen eligible trials, including 1 682 lesions, were included in the quantitative analysis for the efficacy and safety of paclitaxel coated DCBs. DCBs were associated with a lower risk of loss of target lesion patency at six months (HR 0.53, 95% CI 0.42 - 0.66) and 12 months (HR 0.60, 95% CI 0.47 - 0.76), and were also associated with improved six and 12 month circuit patency. Overall quality of evidence was moderate to low. Procedural complications were rare, and the risk of death up to 12 months was similar between the two groups (OR 1.03, 95% CI 0.68 - 1.56). CONCLUSION Paclitaxel coated DCBs reduced the risk of loss of target lesion patency and circuit patency in arteriovenous access stenosis compared with PBs. Considering the heterogeneity of the included trials, there is a need to investigate optimal treatment regimens regarding drug dose and agent of the DCB and the treatment procedure.
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Affiliation(s)
- Ahram Han
- Department of Surgery, Seoul National University College of Medicine, Seoul, South Korea.
| | - Taejin Park
- Department of Surgery, Gyeongsang National University School of Medicine, Jinju, South Korea.
| | - Hyun Jung Kim
- Institute for Evidence Based Medicine, Korea University College of Medicine, Seoul, South Korea
| | - Sangil Min
- Department of Surgery, Seoul National University College of Medicine, Seoul, South Korea
| | - Jongwon Ha
- Department of Surgery, Seoul National University College of Medicine, Seoul, South Korea
| | - Seung-Kee Min
- Department of Surgery, Seoul National University College of Medicine, Seoul, South Korea.
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Heo SJ, Ju YH, Noh EJ, Kim KM, Son YK, Jung SW, Kang HJ, Lee JR, Cho WH, Ha J. A study on the performance of the Donation Improvement Program in Korea. Korean J Transplant 2021; 35:77-85. [PMID: 35769527 PMCID: PMC9235343 DOI: 10.4285/kjt.21.0006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Revised: 06/16/2021] [Accepted: 06/21/2021] [Indexed: 11/04/2022] Open
Abstract
Background Methods Results Conclusions
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Affiliation(s)
- Su Jin Heo
- Korea Organ Donation Agency, Seoul, Korea
| | - Yong Ho Ju
- Korea Organ Donation Agency, Seoul, Korea
| | | | | | | | | | | | | | | | - Jongwon Ha
- Department of Surgery, Seoul National University College of Medicine, Seoul, Korea
- Transplantation Research Institute, Medical Research Center, Seoul National University College of Medicine, Seoul, Korea
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Liu WQ, Bai R, Ma CL, Yu F, Xie B, Dong M, Ha J, Wen D. Metabolomics Changes of Serum and Tissues in Mice Died of Acute Tetracaine Poisoning. Fa Yi Xue Za Zhi 2021; 37:166-174. [PMID: 34142476 DOI: 10.12116/j.issn.1004-5619.2020.401006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Indexed: 11/30/2022]
Abstract
Abstract Objective To study the changes of metabolites in serum and tissues (kidney, liver and heart) of mice died of acute tetracaine poisoning by metabolomics, to search for potential biomarkers and related metabolic pathways, and to provide new ideas for the identification of cause of death and research on toxicological mechanism of acute tetracaine poisoning. Methods Forty ICR mice were randomly divided into control group and acute tetracaine poisoning death group. The model of death from acute poisoning was established by intraperitoneal injection of tetracaine, and the metabolic profile of serum and tissues of mice was obtained by ultra-high performance liquid chromatography-electrostatic field orbitrap high resolution mass spectrometry (UPLC-Orbitrap HRMS). Multivariate statistical principal component analysis (PCA) and orthogonal partial least square-discriminant analysis (OPLS-DA) were used, combined with t-test and fold change to identify the differential metabolites associated with death from acute tetracaine poisoning. Results Compared with the control group, the metabolic profiles of serum and tissues in the mice from acute tetracaine poisoning death group were significantly different. Eleven differential metabolites were identified in serum, including xanthine, spermine, 3-hydroxybutylamine, etc.; twenty-five differential metabolites were identified in liver, including adenylate, adenosine, citric acid, etc.; twelve differential metabolites were identified in heart, including hypoxanthine, guanine, guanosine, etc; four differential metabolites were identified in kidney, including taurochenodeoxycholic acid, 11, 12-epoxyeicosatrienoic acid, dimethylethanolamine and indole. Acute tetracaine poisoning mainly affected purine metabolism, tricarboxylic acid cycle, as well as metabolism of alanine, aspartic acid and glutamic acid. Conclusion The differential metabolites in serum and tissues of mice died of acute tetracaine poisoning are expected to be candidate biomarkers for this cause of death. The results can provide research basis for the mechanism and identification of acute tetracaine poisoning.
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Affiliation(s)
- W Q Liu
- Forensic Identification Center of Hebei Medical University, Collaborative Innovation Center of Forensic Medical Molecular Identification, Hebei Key Laboratory of Forensic Medicine, College of Forensic Medicine, Hebei Medical University, Shijiazhuang 050017, China.,School of Chemical and Pharmaceutical Engineering, Hebei University of Science and Technology, Shijiazhuang 050018, China
| | - R Bai
- Forensic Identification Center of Hebei Medical University, Collaborative Innovation Center of Forensic Medical Molecular Identification, Hebei Key Laboratory of Forensic Medicine, College of Forensic Medicine, Hebei Medical University, Shijiazhuang 050017, China
| | - C L Ma
- Forensic Identification Center of Hebei Medical University, Collaborative Innovation Center of Forensic Medical Molecular Identification, Hebei Key Laboratory of Forensic Medicine, College of Forensic Medicine, Hebei Medical University, Shijiazhuang 050017, China
| | - F Yu
- Forensic Identification Center of Hebei Medical University, Collaborative Innovation Center of Forensic Medical Molecular Identification, Hebei Key Laboratory of Forensic Medicine, College of Forensic Medicine, Hebei Medical University, Shijiazhuang 050017, China
| | - B Xie
- Forensic Identification Center of Hebei Medical University, Collaborative Innovation Center of Forensic Medical Molecular Identification, Hebei Key Laboratory of Forensic Medicine, College of Forensic Medicine, Hebei Medical University, Shijiazhuang 050017, China
| | - M Dong
- Forensic Identification Center of Hebei Medical University, Collaborative Innovation Center of Forensic Medical Molecular Identification, Hebei Key Laboratory of Forensic Medicine, College of Forensic Medicine, Hebei Medical University, Shijiazhuang 050017, China
| | - J Ha
- School of Chemical and Pharmaceutical Engineering, Hebei University of Science and Technology, Shijiazhuang 050018, China
| | - D Wen
- Forensic Identification Center of Hebei Medical University, Collaborative Innovation Center of Forensic Medical Molecular Identification, Hebei Key Laboratory of Forensic Medicine, College of Forensic Medicine, Hebei Medical University, Shijiazhuang 050017, China
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Yu MY, Kwon S, Moon JJ, Kim YC, Song EY, Lee H, Moon KC, Ha J, Kim DK, Han SW, Kim GH, Kim YS, Yang SH. Role of the IL-33/ST2 pathway in renal allograft rejection. Exp Cell Res 2021; 405:112705. [PMID: 34166678 DOI: 10.1016/j.yexcr.2021.112705] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2020] [Revised: 06/04/2021] [Accepted: 06/09/2021] [Indexed: 11/25/2022]
Abstract
The interleukin-33 (IL-33)/suppression of tumorigenicity 2 (ST2) pathway modulates immune response and inflammation, associated with allograft dysfunction and rejection. We hypothesized that IL-33/ST2 is a marker of renal allograft rejection and IL-33/ST2 expression may differ according to rejection type. IL-33/ST2 expression was measured in sera and kidney tissues from recipients with acute antibody-mediated rejection (AAMR), acute cell-mediated rejection (ACMR), chronic antibody-mediated rejection (CAMR), and healthy controls. The soluble ST2 and IL-33/ST2 expression levels were higher in participants with all three rejection types than in controls. Although the expression levels in recipients with AAMR and ACMR were significantly higher than those with CAMR, there was no significant difference between the expression levels in AAMR and ACMR. Although IL-33, IL-8, and fibronectin expression were significantly increased after the addition of the recipients' serum in primary cultured human renal proximal tubular epithelial cells, the levels decreased after treatment with an anti-ST2 antibody. Furthermore, the anti-ST2 antibody specifically suppressed the upregulation of the mixed lymphocyte reaction. Boyden chamber assays demonstrated that anti-ST2 antibody abrogated chemotaxis induced by recombinant IL-33. Thus, IL-33 and ST2 are potent mediators of rejection. Treatment with an anti-ST2 antibody ameliorates rejection and could be a potential therapeutic strategy for renal allograft rejection.
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Affiliation(s)
- Mi-Yeon Yu
- Department of Internal Medicine, Hanyang University Guri Hospital, Guri, South Korea; Department of Internal Medicine, Hanyang University College of Medicine, Seoul, South Korea
| | - Soie Kwon
- Department of Internal Medicine, Seoul National University Hospital, Seoul, South Korea
| | - Jong Joo Moon
- Department of Internal Medicine, Seoul National University Hospital, Seoul, South Korea
| | - Yong-Chul Kim
- Department of Internal Medicine, Seoul National University Hospital, Seoul, South Korea
| | - Eun Young Song
- Department of Laboratory Medicine, Seoul National University Hospital, Seoul, South Korea
| | - Hajeong Lee
- Department of Internal Medicine, Seoul National University Hospital, Seoul, South Korea; Kidney Research Institute, Seoul National University College of Medicine, Seoul, South Korea
| | - Kyung Chul Moon
- Kidney Research Institute, Seoul National University College of Medicine, Seoul, South Korea; Department of Pathology, Seoul National University Hospital, Seoul, South Korea
| | - Jongwon Ha
- Department of Surgery, Seoul National University Hospital, Seoul, South Korea
| | - Dong Ki Kim
- Department of Internal Medicine, Seoul National University Hospital, Seoul, South Korea; Kidney Research Institute, Seoul National University College of Medicine, Seoul, South Korea
| | - Sang-Woong Han
- Department of Internal Medicine, Hanyang University Guri Hospital, Guri, South Korea; Department of Internal Medicine, Hanyang University College of Medicine, Seoul, South Korea
| | - Gheun-Ho Kim
- Department of Internal Medicine, Hanyang University College of Medicine, Seoul, South Korea
| | - Yon Su Kim
- Department of Internal Medicine, Seoul National University Hospital, Seoul, South Korea; Kidney Research Institute, Seoul National University College of Medicine, Seoul, South Korea
| | - Seung Hee Yang
- Kidney Research Institute, Seoul National University College of Medicine, Seoul, South Korea; Biomedical Research Institute, Seoul National University Hospital, Seoul, South Korea.
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Kim H, Ahn S, Kim M, Chung CTY, Choi KW, Ko H, Han A, Min S, Min SK, Ha J. Comparison between autogenous brachial-brachial upper-arm elevated direct arteriovenous fistulas and prosthetic brachial-antecubital indirect forearm arteriovenous grafts. J Vasc Access 2021; 23:936-945. [PMID: 34058911 DOI: 10.1177/11297298211018020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVES The National Kidney Foundation Kidney Disease Outcomes Quality Initiative (NKF-KDOQI) guidelines recommend forearm arteriovenous grafts (AVGs) as an alternative procedure to transposed basilic vein fistulas for providing secondary access during hemodialysis. Recently, autogenous elevated brachial-brachial vein fistulas (BVE) have become increasingly popular. The aim of this study was to compare the outcomes of BVE and forearm loop AVG (AVG) for secondary access in hemodialysis. METHODS We retrospectively reviewed the medical records of patients who had received a BVE or forearm AVG at a single center from January 2015 to April 2019. In total, 19 BVE were created via two-stage operations and two via a one-stage operation; 53 forearm AVG's were performed. RESULTS The AVG group was twice as likely to suffer loss of primary patency compared with the BVE group (odds ratio [OR], 2.666; 95% confidence interval [CI], 1.108-6.412; p = 0.029) per the multivariate analysis. The primary patency and primary assisted patency of the BVE group were superior those of the AVG group, except for secondary patency (p = 0.02, p = 0.07, p = 0.879, respectively). In subgroup analysis, there were no significant differences in primary, primary assisted, or secondary patency between AVG and BVE when brachial vein was used for AVG outflow. In addition, no significant differences were noted regarding the infection rate (12.5% vs 12.3%, p = 0.331, severity >0), postoperative bleeding rate (14.5% vs 3.5%, p = 0.191, severity >1), early thrombus rate (0.0% vs 10.5%, p = 0.122), and early failure rate (7% vs 4.8%, p = 0.591). CONCLUSIONS The primary patency and primary assisted patency rates of BVE were significantly better than those observed in AVGs, but the complication rates were similar. The appropriate procedure to provide vascular access should be determined by the individual patient's condition and the surgical skill of the operating surgeon.
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Affiliation(s)
- Hyokee Kim
- Department of Surgery, Seoul National University Hospital, Seoul, Korea
| | - Sanghyun Ahn
- Department of Surgery, Seoul National University Hospital, Seoul, Korea
| | - Minseob Kim
- Department of Surgery, Seoul National University Hospital, Seoul, Korea
| | | | - Kwang Woo Choi
- Department of Surgery, Seoul National University Hospital, Seoul, Korea
| | - Hyunmin Ko
- Department of Surgery, Seoul National University Hospital, Seoul, Korea
| | - Ahram Han
- Department of Surgery, Seoul National University Hospital, Seoul, Korea
| | - Sangil Min
- Department of Surgery, Seoul National University Hospital, Seoul, Korea
| | - Seung-Kee Min
- Department of Surgery, Seoul National University Hospital, Seoul, Korea
| | - Jongwon Ha
- Department of Surgery, Seoul National University Hospital, Seoul, Korea
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