Triple combination of low-dose cyclosporine, azathioprine, and steroids in first cadaver donor renal allografts.
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Biomedical subjects
Publications and source records attributed to C Hiesse.
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The rejection of an allograft is a complex phenomenon involving various subsets of immune cells. If the role of humoral immunity and cytotoxic T cells is well demonstrated, helper T cells have also a major effect in some models of allograft destruction. Moreover, Natural Killer cells, Killer cells, monocytes/macrophages, B lymphocytes are also implicated in various stages of graft rejection. The analysis of the clonal repertoire of T lymphocytes, the discovery of the structure and function of the T-cell receptor and finally the genetic control by encoded genes of the immune response may lead to a better comprehensive and therapeutic approach of graft rejection.
The authors report a case of testicular malakoplakia in a renal transplant patient. They emphasise the predisposing role of immunosuppression which was particularly intense in this patient and they stress the risk of dissemination of the disease to the graft.
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We report a case of fulminant hepatocellular carcinoma discovered 50 days after renal transplantation. The recipient was a young Senegalese, hepatitis B virus chronic carrier. The pre-transplant check-up was normal, and the tumor was latent until its dramatic expression. Progression of hepatitis B liver disease occurs in immuno-suppressed renal transplant recipients, which often leads to chronic active hepatitis, cirrhosis and hepatocellular carcinoma, with a high risk of death due to liver disease. The early discovery of the tumor in this patient emphasizes the necessity for complete hepatic screening before transplantation in african, hepatitis B virus chronic carrier recipients. Moreover, the accumulation of risk factors for hepatocellular carcinoma: hepatitis B virus, food mycotoxins (aflatoxin), parasitic infestation and immunosuppression with transplantation is stressed.
In a 66-year-old female patient with a past history of tuberculosis, prolonged fever at 38 degrees C accompanied by a strong increase in ESR ultimately led to the diagnosis of renal cyst. Biopsies of renal tissue and of lymph nodes taken during surgery showed renal granulomatosis without caseum. Despite negative bacterial findings and anergy to tuberculin, an anti-tuberculous treatment was administered and the patient recovered.
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