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Background: Gallstone disease (GD) is common but remains asymptomatic in most cases. However, gallstones can lead to complications like choledocholithiasis or gallbladder cancer. In this study, we analyse the common genetic risk factor for GD, the p.D19H variant in the sterol transporter ABCG8, in Polish patients with gallstones and gallbladder cancer. Methods: Three adult cohorts were prospectively recruited: 65 patients with gallbladder cancer, 170 obese individuals scheduled for bariatric surgery and 72 patients who underwent endoscopic retrograde cholangiopancreatography due to recurrent choledocholithiasis. The control cohort consisted of 172 gallstone‐free adults. The ABCG8 p.D19H (rs11887534) polymorphism was genotyped using TaqMan assays. Results: The minor allele frequency (MAF) of the ABCG8 p.D19H polymorphism was significantly (p =.02) higher among cases with either gallstones or gallbladder cancer (MAF = 8.4%) as compared to controls (MAF = 4.0%). The highest frequency of the risk allele was detected in patients with gallbladder cancer (18.5%) and obese patients with GD (17.5%), followed by individuals with choledocholithiasis (13.9%). Notably, the p.19H variant was associated with an increased risk of developing gallbladder cancer (OR 2.76, 95% CI 1.16–6.54, p =.01) and an increased risk of GD in obese individuals scheduled for bariatric surgery (OR = 2.70, 95% CI 1.05–6.49, p =.03), but did not significantly affect the risk of choledocholithiasis. Conclusions: The ABCG8 p.D19H common risk variant increases the risk of developing gallbladder cancer in Central Europeans and enhances the risk of gallstones in the obese. Carriers of the p.D19H variant might benefit from personalized preventive strategies, particularly regarding gallbladder cancer. [ABSTRACT FROM AUTHOR]

The positive result of complement-dependent cytotoxicity crossmatch (CDC XM) may not constitute a contraindication to renal transplantation, unless it is mediated by IgM antibodies, particularly of the autologous type. The current work presents the evaluation of the frequency of reactive IgM antibodies in sensitized kidney patients in Poland and their influence on panel-reactive antibodies (PRAs) readout and allocation status. Results of PRA CDC assay with and without dithiothreitol were elaborated in 53 prospective recipients with historic PRA of ≥50%. Delta PRA (dPRA) was calculated. Retrospective analysis of the results in the context of age, sex, transplant number, and cause of end-stage renal failure was performed. Reactive IgM antibodies were detected in 81% of patients. Panel reactivity completely disappeared in 4% and in 51% of recipients PRA decreased by 2 to 77 percentage points. In 14 patients, PRA increased, and in 10, its level did not change. The allocation was altered in 36% of recipients. Priority status was lost in 8 and gained in 3 cases. Additional points for high sensitization were obtained in 1 and lost in 7 patients. dPRA was significantly greater in patients awaiting the first transplant compared with the second (P =.007) and third (P =.002). Higher dPRA was also symptomatic for autoimmune patients (P =.025). Reactive IgM antibodies affected PRA level and allocation in a considerable group of sensitized patients in Poland. Discrimination of IgM from IgG antibodies should be introduced to the recipient qualification algorithm. • Reactive IgMs overestimate the recipient's sensitization and alter allocation. • Irrelevant IgMs in patients' sera limit access to kidney transplantation. • Dithiothreitol-sensitive antibodies are characteristic of autoimmune disease. [ABSTRACT FROM AUTHOR]

Background: Liver transplantation is a life-saving and successful therapeutic procedure which is more and more frequent worldwide, also among women of reproductive age. Consequently, there is an increasing number of reports of pregnancy following liver transplantation, but doubts still exist regarding preconception counseling and the optimal method of managing pregnancy. The aim of this study was to report and evaluate pregnancy outcomes in women who had undergone liver transplantation., Methods: We retrospectively analyzed female patients after orthotopic liver transplantation who reported pregnancy and were under medical care of a single transplant center., Results: We identified 14 pregnancies in 10 women who had undergone liver transplantation (12 childbirths, one induced abortion due to fetal death in the first trimester, one pregnancy is still ongoing). Causes of transplantation include congenital or acquired disorders and the most common indication was autoimmune hepatitis (50%). The mean age at the point of transplantation was 28.5 (range 21-36), mean maternal age at pregnancy was 32 (range 26-43), and transplant-to-pregnancy interval was 4.07 years (range 1.5-7). The mean gestational week was 36.67 (range 31-40). Immunosuppression was maintained with combinations of prednisone (n = 11), tacrolimus (n = 13), and azathioprine (n = 8) prior to and during pregnancy. Two pregnancies were unintended, so women took mycophenolate mofetil in the first weeks of gestation. Another two women stopped taking azathioprine due to increasing anemia. Maternal complications included increase of aspartate transaminase and alanine transaminase (n = 2), anemia (n = 4) and hyperthyroidism (n = 2). Among the 12 childbirths, five (41.67%) were preterm. Only five women entered labor spontaneously, while seven (58,33%) had cesarean delivery., Conclusions: Pregnancy after liver transplantation can achieve relatively favorable outcomes. Liver transplantation does not influence women's fertility and, during pregnancy, we report low rates of minor graft complications. A multidisciplinary team should be involved in contraceptive, fertility and consequently pregnancy counseling of female transplant recipients., (© 2021. The Author(s).)

Unlabelled: Some of living kidney donors have medical conditions associated with future risk of cardiovascular diseases. It seems justified to identify risk factors and cardiological disorders prior to the donation., Aim: To determine the cardiological status of persons qualified as a living kidney donor., Material and Methods: We analyzed the data of 109 potential living kidney donors, aged 25-70 (mean 45.7 ± 10.9) years. They underwent clinical and biochemical examination. In some of them extended diagnostics was performed. The presence of risk factors of coronary artery disease were registered., Results: Only 46 (42%) persons were qualified for kidney donation. As many as 40 of them had 21 risk factor. In 75 (68.8%) patients without hypertension, 24-hours ambulatory blood pressure monitoring was done. The masked hypertension was found in 6 persons. In 22 candidates aged > 50 years the exercise test was performed (positive or inconclusive in 3 persons). Coronarography was done in 5 individuals (in no any significant atherosclerotic lesions were found). 63 (58%) person were disqualified. In 15 (23.8%) person the reasons were cardiological. In 2 patient the abdominal aneurysms were found. Both men smoked and had severe dyslipidaemias. In 3rd patient we observed persistent atrial fibrillation. The next 2 men had the peripheral occlusive arterial disease. In 9 patients ≥ 2 risk factors and in the last one morbid obesity were present., Conclusion: In Poland candidates for living kidney donation have very often risk factors of cardiovascular disease. Among the persons proceeded for kidney donation cardiovascular problems are an important cause of disqualification.

Background: The living kidney donor is exposed to the renal function impairment as a result of kidney donation, which may increase the risk of cardiovascular diseases. It seems justified to identify cardiovascular risk factors prior to kidney donation., Material and Methods: We analyzed data of 50 consecutive potential kidney donors. All individuals underwent clinical examination and lipid profile. For each subject we calculated atherogenic index. To calculate the 10-year risk of cardiovascular death, the HeartScore calculator was used., Results: The most frequent risk factors were obesity, lipid disorders, and smoking. In 72% of subjects, at least 1 of the risk factors was detected. Atherogenic index values considered to indicate high risk of atherosclerosis were found in 16% of subjects. More than 40% of subjects had more than 1 coronary risk factor, and most had 2. In 58% of subjects, the calculated HeartScore risk value was consistent with risk estimated for age, and in 26% it exceeded this value by 1-9% (mean, 3.1%)., Conclusions: The prevalence of coronary risk factors is high in potential kidney donors. HeartScore seems to be a useful method to evaluate the risk of cardiovascular mortality in these individuals, and is a simple tool to use in controlling the influence of the modification of risk factors on the global risk in follow-up. Comparison with the value of risk acceptable according to age and sex may oblige the physician to take action to reduce it.

The human immunodeficiency virus (HIV) pandemic has spread to every country in the world and has infected about 60 million persons worldwide, including 20 million who have already died. In Poland are infected 11,181 people. Highly active antiretroviral therapy (HART) has significantly prolonged the survival of HIV-positive patient. HIV infection can cause end-stage renal disease (ESRD) through both HIV-associated nephropathy (HIVAN) and antiretroviral drug toxicity. Until recently, chronic dialysis (HD or PD) was the only form of treatment available for these patients. Kidney transplantation is an alternative method to dialysis and improve the quality of life in HIV-positive ESRD patients. In this article authors present the general information about HIV infection (epidemiology, diagnosis and treatment) as well as methods of therapy ESRD like hemodialysis (HD), peritoneal dialysis (PD) and kidney transplantation.

A serological survey of 78 zoologist capturing small wild rodents in their environment, 9 patients with suspected hantavirus infections and 21 patients with acute renal dysfunction for antibodies to hantaviruses was conducted in Poland. Survey was done by the indirect ELISA with Puumala and Hantaan virus antigens. Out of the 78 mammalogists 15 were seropositive for hantavirus Puumala IgG without history of clinical illness. Analysis of relation between reactive zoologist's sera IgG with antigens of Puumala and Hantaan viruses suggests that these persons had contact with Puumala/Tula viruses rather than with Dobrava/Saaremaa complex. Analysis of results of IgG and IgM presence by ELISA test have confirmed correct interpretation criteria proposed by manufacturer for serological diagnosis of suspected hantavirus infection. Both cross and unspecific reactions in the some sera have been observed. Low number of patients with suspected hantavirus infection suggests the existence of underestimation in registration of data collected in Poland and existence of non-diagnosed infections with hantaviring.