Functional Hyposplenism in Long-Standing Renal Transplant Recipients

Araújo, Nordeval Cavalcante; Lucena, S.; Rioja, S

doi:10.1016/j.transproceed.2013.01.061

Cited by 5 publications

(4 citation statements)

References 20 publications

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“…The protocol for spleen sonography has already been reported elsewhere 13 . In brief, different angles of insonation at different sites were performed in order to display the best image, in which the most cranial and most caudal edge of the spleen were seen in the scan plane for measuring spleen length.…”

Section: Methodsmentioning

confidence: 99%

“…On the other hand, hyposplenism has also been reported to be associated with some conditions that cause end-stage renal disease (ESRD) [11][12] . Moreover, the association between hyposplenism and renal transplantation has been established based on Howell-Jolly bodies in blood smears 13 and hepatosplenic scintigraphy 14 . However, it has not been determined if hyposplenism develops after transplantation or if the condition is already present before starting immunosuppression.…”

Section: Introductionmentioning

confidence: 99%

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The spleen size in patients undergoing hemodialysis

Araújo

Suassuna

2021

Braz. J. Nephrol.

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Introduction: Inflammation promotes the progression of chronic renal failure, and the start of dialysis worsens inflammation. The enlargement of the spleen is associated with inflammation, and patients on hemodialysis may show a large spleen. The aim of the present study was to compare the spleen size of patients undergoing hemodialysis versus controls to update this thread. Methods: Controls and patients were eligible to participate in the study provided they were negative for serological markers of hepatitis B and C viruses and HIV, if they had no lymphoproliferative disorder, and if they were at least 18 years of age. Age, sex, and the duration of dialysis were recorded. Laboratory variables (hemoglobin, hematological cell count, serum creatinine) and the underlying cause of end-stage renal disease were analyzed. The spleen sizes of the patients were divided into tertiles. Results: The 75 controls and 168 patients selected were sex-matched. The patients were older, had larger spleens and lower platelet counts than controls. The relationship between spleen size and age in the controls and patients was quite similar. The patients in the first tertile of spleen size compared with those in the third were older and had a higher platelet counts. The underlying disease and dialysis vintage had no effect on spleen size. Discussion: The patients had larger spleens and a greater range of spleen sizes than the controls. In patients, the association between larger and smaller spleen with lower and higher platelet counts, respectively, sparked the speculation of occurrence of hypersplenism and hyposplenism.

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Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

The spleen size in patients undergoing hemodialysis

Araújo

Suassuna

2021

Braz. J. Nephrol.

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“…A more detailed description of sampling has been already provided elsewhere for the kidney graft and spleen [ 28 ]. Briefly, the RI measurements were sampled at the level of the three interlobar arteries, in the upper, middle and lower poles of the kidney graft.…”

Section: Methodsmentioning

confidence: 99%

Transcranial sonography depicts a larger substantia nigra echogenic area in renal transplant patients on calcineurin inhibitors than on rapamycin

2022

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Background After kidney transplantation neurologic manifestations may develop, including Parkinson’s disease (PD). An enlarged substantia nigra (SN) by transcranial sonography has been recognized as a marker of PD. Methods In renal transplant recipients (RTRs = 95) and controls (n = 20), measurement of mesencephalon, SN, third ventricle, spleen and carotid intima-media thickness (cIMT) and middle cerebral artery (MCA), kidney and spleen arteries Doppler resistive index (RI) were performed. Results RTRs had larger SN, third ventricle and cIMT and higher renal RI than controls. The SN was larger in the CNIs group than in controls and rapamycin group, while the third ventricle was similar between patients but larger than in controls. In RTRs, SN showed a direct linear correlation with spleen and the third ventricle with age, cIMT and RI of the MCA, kidney and spleen. In CNIs group the SN correlated positively with age and cIMT, while the third ventricle reproduced RTRs correlations. Rapamycin group showed a direct linear relationship between the third ventricle and age and RI of the MCA, kidney and spleen; SN showed no correlations. Conclusion RTRs on CNIs present a larger SN area than on rapamycin, probably due to the antiproliferative effect of rapamycin. This finding might be relevant when interpreting TCS in RTRs.

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“…Despite an extensive literature of medical conditions associated with FH, like sickle cell anemia, [ 6 ] allogenic bone marrow transplantation, [ 7 ] inflammatory bowel disease, [ 8 ] celiac disease, [ 9 ] systemic lupus erythematosus, [ 10 ] and amyloidosis [ 11 ] has been known for decades, to our knowledge a series addressing this issue in renal transplant recipients has been reported only recently. [ 12 ] FH is now well-recognized as a condition associated with several diseases potentially at risk for developing the disorder and occasionally along with a small spleen. [ 5 , 13 , 14 ]…”

Section: Introductionmentioning

confidence: 99%

Howell-Jolly bodies and liver-spleen scanning for assessment of splenic filtrative function yields discordant results in renal transplant recipients

Araújo¹,

Orlando

Neves

et al. 2017

Medicine

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Given discrepancies between methods for diagnosing hyposplenism, the purpose of this study was to evaluate the effect of the spleen size on the correlation between the methods, and to propose a model for improving the interpretation. Patients with renal allografts were included, in whom the spleen was assessed using Doppler ultrasound, scintiscan, and the presence of Howell-Jolly bodies (HJBs) in peripheral smears. In 35 subjects, scintiscan and HJBs were normal (Group 0); 20 had an abnormal result in both methods (Group 1); 34 had discordant results with HJBs present (Group 2); and 14 had discordant results with decreased spleen uptake (Group 3). There was no association between HJBs and scintiscan. The patients of Groups 1 and 2 had smaller spleens. The patients with smaller spleen had more hematological evidence of hyposplenism and exhibit smaller discrepancies between the methods than patients with larger spleen. The spleen can tip the balance from a normal to impaired function provided that the spleen size is below the critical mass required to maintain splenic function. A mild impairment of phagocytic function and slight dyserythropoiesis along with a small spleen would result in decreased take up of radiocolloid or the appearance of HJBs in blood smears.

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Functional Hyposplenism in Long-Standing Renal Transplant Recipients

Cited by 5 publications

References 20 publications

The spleen size in patients undergoing hemodialysis

The spleen size in patients undergoing hemodialysis

Transcranial sonography depicts a larger substantia nigra echogenic area in renal transplant patients on calcineurin inhibitors than on rapamycin

Howell-Jolly bodies and liver-spleen scanning for assessment of splenic filtrative function yields discordant results in renal transplant recipients

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