Hongfeng Huang

Kidney Transplantation from Hepatitis B Surface Antigen Positive Donors into Hepatitis B Surface Antibody Positive Recipients: A Prospective Nonrandomized Controlled Study from a Single Center

The number of patients on renal transplant waiting list is increasing rapidly in many countries, exacerbating the shortage of organs. We conducted a study to evaluate the safety and efficacy of deceased‐donor kidney transplantation from hepatitis B surface antigen (HBsAg)‐positive (+) donors into hepatitis B surface antibody (anti‐HBs)‐positive (+) recipients. Sixty‐five patients received grafts from HBsAg(+) donors, and 308 subjects received grafts from HBsAg‐negative(−) donors. Posttransplantation, recipients with HBsAg(−) grafts or HBsAg(+) grafts received 400 U of hepatitis B immunoglobulin once and twice, respectively. The seven recipients who received grafts from hepatitis B virus (HBV) DNA(+) donors were treated with hepatitis B immunoglobulin 400 U weekly for 3 months and lamivudine 100 mg daily for 6 months. All patients were monitored for liver function and hepatitis B viral status. The follow‐up period was 38.7 ± 15.4 months. Although two recipients developed de novo HBV infection, neither patient developed severe liver dysfunction nor died. The incidence of liver injury (39/65 vs. 207/308, chi‐square test, p > 0.05) and survival (log‐rank test, p > 0.05) did not differ between the groups. We conclude that anti‐HBs(+) recipients receiving HBsAg(+) grafts did as well as those receiving HBsAg(−) grafts.

Nocardia infection in kidney transplant recipients: case report and analysis of 66 published cases

X. Yu, F. Han, J. Wu, Q. He, W. Peng, Y. Wang, H. Huang, H. Li, R. Wang, J. Chen. Nocardia infection in kidney transplant recipients: case report and analysis of 66 published cases.
Transpl Infect Dis 2011: 13: 385–391. All rights reserved

Slope of changes in renal function in the first year post-transplantation and one-yr estimated glomerular filtration rate together predict long-term renal allograft survival.

Wu J, Li H, Huang H, Wang R, Wang Y, He Q, Chen J. Slope of changes in renal function in the first year post‐transplantation and one‐yr estimated glomerular filtration rate together predict long‐term renal allograft survival. 
Clin Transplant 2010: 24: 862–868.

The effect of donor-recipient gender mismatch on short- and long-term graft survival in kidney transplantation: a systematic review and meta-analysis.

There is no limitation of gender matching in renal transplantation. This study was intended to evaluate its effect on short‐ and long‐term graft survival.

C4d deposition in allograft renal biopsies is an independent risk factor for graft failure.

Aim:  Association between C4d deposition and renal allograft survival is still uncertain. We retrospectively evaluated the clinical outcome of C4d deposition in allograft renal biopsies.

Aspergillus infection limited to the anastomosed artery following renal transplantation: a report of 4 cases.

Abstract: We present 4 cases of Aspergillus fumigatus infection limited to the anastomosed artery following renal transplantation. All grafts were nephrectomized. Two patients received 2 weeks of itraconazole therapy; both showing recurrence of pseudoaneurysms following discontinuation of therapy. Another 2 patients received 3 months of itraconazole therapy without recurrence of pseudoaneurysms. Surgical interventions were life saving. Resection of infected tissues and 3 months of antifungal therapy seemed to give better results than shorter antifungal strategies.

Interleukin‐2 receptor antagonist compared with antithymocyte globulin induction therapy in kidney transplantation from donors after cardiac death

The aim of this study was to compare the efficacy and safety of induction therapy using the interleukin‐2 receptor antagonist (IL‐2RA) with antithymocyte globulin (ATG) under a tacrolimus‐based immunosuppression regimen in kidney transplantation from donors after cardiac death.

Peritubular Capillaritis in Early Renal Allograft Dysfunction Is an Indicator of Acute Rejection

BACKGROUND Kidneys showing acute rejection (AR) processes often are accompanied by various levels of peritubular capillaritis (Ptc), especially cases of acute humoral rejection (AHR). However, it is not known whether the presence of Ptc alone is sufficient evidence of allograft rejection. This study was performed to determine the diagnostic value of Ptc as a marker for AR among cases of early renal allograft dysfunction. METHODS Fifty-three AR showed C4d deposition in the peritubular capillaries (PTCs; C4d+AR group), 50 AR were without C4d deposition (C4d-AR group), 30 had Ptc alone (Ptc group), 28 had acute tubular necrosis (ATN group), and 78 were surveillance biopsies (control group). RESULTS Analyzing the immunophenotype of infiltrating T lymphocytes and serum antibodies, discovered that 85.9% of control biopsies presented with a regulatory phenotype. Among the Ptc cohort, 93.3% of biopsies showed the cytotoxic phenotype with no significant different between C4d+AR and C4d-AR (96.2% vs 92.0%). We also observed the prevalence of panel-reactive antibody (PRA) and major-histocompatibility-complex class I chain-related gene A (MICA) antibodies to be increased among Ptc (30.0% and 43.3%, respectively), albeit not significantly different from C4d+AR (49.1% and 39.6%, respectively). The prevalences were low in other groups. CONCLUSIONS These results implied that Ptc in biopsy specimens from patients with early renal allograft dysfunction was an indicator of AR, especially AHR.

Biomarkers for Early Diagnosis of Acute Kidney Injury: Current Progress and Clinical Prospects

Acute kidney injury (AKI) is one of the most common complications in critically ill patients, resulting in high morbidity and mortality. AKI usually occurs after major surgery, severe infection or drug-induced nephrotoxicity and is associated with prolonged hospital stays, increased costs and adverse clinical outcomes. The diagnosis of AKI is currently based on decreased glomerular filtration rate (GFR) and urine output, and increased serum creatinine. Novel biomarkers are required for early identification of patients with AKI to allow timely therapy and improve patient outcomes. With the advent of proteomics and genomics techniques, a vast array of biomarkers are now available in clinical practice.

Simple Cysts in Donor Kidney Contribute to Reduced Allograft Function

Background: Simple renal cysts may be an early marker of renal disease. We investigated whether simple cysts in donor kidney are associated with the decline of allograft function in living donor kidney transplantation. Methods: We retrospectively reviewed records of donors and recipients from 716 living donor kidney transplants performed between April 2007 and April 2015 in our hospital. Ninety-one donors with renal cysts and 64 recipients with cysts in donor kidney were noted. We compared these 64 cases to 128 no cyst-bearing controls matched for the donor gender, recipient gender, donor baseline serum creatinine (sCr), donor/recipient body surface area ratio, donor age, recipient age and the date of kidney transplantation in turn. Results: The presence of cysts was interrelated with age, gender and renal function independently in donors. Pathological findings of time-zero biopsy revealed that donor kidney harboring cysts existed more glomerular sclerosis compared with no cyst-bearing controls (p = 0.040). The estimating glomerular filtration rate levels of recipients were 80.82 ± 26.61 vs. 88.21 ± 23.12, 66.95 ± 17.42 vs. 72.15 ± 16.42 and 60.92 ± 22.17 vs. 68.72 ± 14.43 ml/min· 1.73 m2 in cyst-bearing and no cyst-bearing group on day 7, month 6 and year 5, respectively, after surgery (p < 0.05). The mean sCr were 112.14 ± 48.32 vs. 98.75 ± 29.71 and 126.28 ± 42.32 vs. 115.05 ± 26.35 μmol/l on the 7th day and a half year after transplant, respectively (p < 0.05). The 2 groups did not significantly differ in terms of the other characteristics. Conclusion: Simple cysts in donor kidney can influence the early and long-term allograft function. In living donor transplantation, kidney presenting cysts should be considered carefully at the time of donor selection.