The impact of obesity in renal transplantation: an analysis of paired cadaver kidneys.

Abstract:

BACKGROUND:Previous studies indicate that obesity is a risk factor in renal transplantation. However, these analyses did not control for variable donor factors that may strongly influence outcome. To control for donor variables such as age, cause of death, procurement techniques, preservation methods, cold ischaemia time and implantation technique, we analysed patient and graft survival in recipients of paired kidneys, derived from the same procurement procedure, preserved in the same manner, subjected to similar cold ischaemia time and implanted by the same surgical team. Between June 1992 and August 1999, 28 procurement procedures provided kidneys which were transplanted into one obese and one non-obese recipient. Body mass index (BMI) was calculated as kg/m2. Recipients were classified as obese (BMI > 30) or non-obese (BMI < 30). Immunotherapy for all recipients consisted of a triple therapy regimen of cyclosporine or prograf, azathioprine or cellcept, and prednisone. Patients with delayed graft function (DGF), defined as the need for dialysis within 72 h of the transplant procedure, were treated with anti-thymocyte globulin (ATG) or thymoglobulin (TMG) induction for 5-7 d. The rate of DGF (7.1 versus 10.7%) and acute rejection (39.3 versus 35.7%) were similar in the obese and non-obese recipient groups. Patient survival was similar at 1, 3 and 5 yr in both groups. In addition, graft survival was similar at 1 yr. However, a trend toward decreased medium-term graft survival, which reached significance at 5 yr, was observed in the obese group. Furthermore, mean serum creatinine at 1 yr was higher in the obese group (2.0) compared with the non-obese group (1, 4) (p=0.12). This analysis of paired cadaver kidneys indicated that obesity is not a risk factor for DGF, acute rejection, and 1-yr graft survival. However, a decreased medium- and long-term graft survival trend, which reached statistical significance at 5 yr, was observed in obese recipients.

journal_name

Clin Transplant

journal_title

Clinical transplantation

authors

Yamamoto S,Hanley E,Hahn AB,Isenberg A,Singh TP,Cohen D,Conti DJ

doi

10.1034/j.1399-0012.2002.01080.x

subject

Has Abstract

pub_date

2002-08-01 00:00:00

pages

252-6

issue

4

eissn

0902-0063

issn

1399-0012

pii

1o080

journal_volume

16

pub_type

杂志文章
  • Reversal of accelerated renal allograft rejection with FK 506.

    abstract::Although FK 506 has been shown to effectively reverse refractory renal allograft rejection, its ability to reverse accelerated renal allograft rejection as a primary agent has not been specifically addressed. Herein evidence of the ability of FK 506 to reverse accelerated renal allograft rejection is presented. A 16-y...

    journal_title:Clinical transplantation

    pub_type: 杂志文章

    doi:

    authors: Woodle ES,Newell KA,Haas M,Bartosh S,Josephson MA,Millis JM,Bruce DS,Piper JB,Aronson AJ,Thistlethwaite JR

    更新日期:1997-08-01 00:00:00

  • Interstitial alterations in renal cortex in acute tubular necrosis (ATN) post-renal transplantation and in patients with ATN not related to renal transplant.

    abstract:BACKGROUND:Abnormalities of renal function with long-term implications can persist after acute tubular necrosis (ATN), probably because of permanent loss of nephrons. Residual areas of fibrosis are also observed in the renal cortex post-ATN. In this study, we investigate the interstitial alterations post-ATN using hist...

    journal_title:Clinical transplantation

    pub_type: 杂志文章

    doi:10.1046/j.1399-0012.2003.00140.x

    authors: Moyses Neto M,Costa RS,Volpini RA,Garcia TM,Rodrigues FF,Coimbra TM

    更新日期:2004-04-01 00:00:00

  • Calciphylaxis in end-stage liver and renal disease patients before and after transplant.

    abstract::Calciphylaxis is a rare vascular disorder characterized by calcification of arterioles which causes tissue inflammation and necrosis. It is associated with the metabolic disturbances seen in end-stage renal disease (ESRD) and has also been described in patients with cirrhosis with preserved kidney function. Characteri...

    journal_title:Clinical transplantation

    pub_type: 杂志文章,评审

    doi:10.1111/ctr.13272

    authors: Couri T,Stier M,Mikolajczyk A,Aronsohn A

    更新日期:2018-06-01 00:00:00

  • Sequential biological immunosuppression. Induction therapy with rabbit antithymocyte globulin.

    abstract::This paper describes 108 consecutively treated patients receiving 109 cadaveric (CD) and living donor (LD) renal allografts using a protocol of quadruple sequential immunosuppression with a rabbit anti-human thymocyte IgG (Thymoglobuline), azathioprine, tapering corticosteroids, and delayed introduction of cyclosporin...

    journal_title:Clinical transplantation

    pub_type: 杂志文章

    doi:

    authors: Guttmann RD,Flemming C

    更新日期:1997-06-01 00:00:00

  • Everolimus leads to a lower risk of BKV viremia than mycophenolic acid in de novo renal transplantation patients: a single-center experience.

    abstract:BACKGROUND:There are limited published data concerning the effects of different immunosuppressive regimens on the development of polyomavirus (BKV) viremia. We examined the risk of developing BKV viremia in kidney transplant recipients receiving everolimus (EVR) or mycophenolic acid (MPA) as maintenance therapy. METHO...

    journal_title:Clinical transplantation

    pub_type: 临床试验,杂志文章

    doi:10.1111/ctr.12151

    authors: Moscarelli L,Caroti L,Antognoli G,Zanazzi M,Di Maria L,Carta P,Minetti E

    更新日期:2013-07-01 00:00:00

  • Urinary tract infections after renal transplantation: a retrospective review at two US transplant centers.

    abstract::Urinary tract infections (UTIs) are the most common infectious complication following renal transplantation. Previous studies uniformly report that renal transplant recipients develop UTIs more often than the general population, but widely differ on how frequently UTIs occur after transplantation. These studies also d...

    journal_title:Clinical transplantation

    pub_type: 杂志文章

    doi:10.1111/j.1399-0012.2005.00327.x

    authors: Chuang P,Parikh CR,Langone A

    更新日期:2005-04-01 00:00:00

  • Engraftment of heavily transfused patients with severe aplastic anemia with a fludarabine-based regimen.

    abstract::We have developed a practical conditioning regimen without anti-thymocyte globulin (ATG), irradiation, or other myeloablative alkylating agent for low-income countries in which patients with severe aplastic anemia (SAA), who usually have heavily transfused and a prolonged disease history. The application of ATG, Busul...

    journal_title:Clinical transplantation

    pub_type: 临床试验,杂志文章

    doi:10.1111/ctr.12061

    authors: Wang SB,Li L,Pan XH,Hu DM,Peng LH,Liu L,Xie ZJ,Yin B,Sun XJ,Yu J,Liang Y

    更新日期:2013-03-01 00:00:00

  • Overview of reduced-size liver transplantation.

    abstract::Organ donor availability is the major limiting factor in pediatric liver transplantation, and many children succumb from their liver disease before a suitable donor can be found. In an attempt to overcome this shortage, reduced-size liver transplantation, split liver transplantation, and living-donor liver transplanta...

    journal_title:Clinical transplantation

    pub_type: 杂志文章,评审

    doi:

    authors: Emond JC,Whitington PF,Broelsch CE

    更新日期:1991-04-01 00:00:00

  • Outcomes after simultaneous kidney-pancreas versus pancreas after kidney transplantation in the current era.

    abstract::Simultaneous pancreas and kidney (SPK) and pancreas after kidney (PAK) transplant are both potential options for diabetic ESRD patients. Historically, PAK pancreas graft outcomes were felt to be inferior to SPK pancreas graft outcomes. Little is known about outcomes in the modern era of transplantation. We analyzed ou...

    journal_title:Clinical transplantation

    pub_type: 临床试验,杂志文章

    doi:10.1111/ctr.13732

    authors: Parajuli S,Arunachalam A,Swanson KJ,Aziz F,Garg N,Redfield RR,Kaufman D,Djamali A,Odorico J,Mandelbrot DA

    更新日期:2019-12-01 00:00:00

  • Itraconazole for the treatment of pulmonary aspergillosis in heart transplant recipients.

    abstract::The objective of this study was to evaluate the effects of itraconazole as a first choice drug in the treatment of pulmonary aspergillosis in heart transplant recipients. Heart transplant recipients suffering from invasive pulmonary aspergillosis were included in this study. Group 1 included 4 patients treated with i....

    journal_title:Clinical transplantation

    pub_type: 杂志文章

    doi:

    authors: Nanas JN,Saroglou G,Anastasiou-Nana MI,Kostis EB,Petrochilou-Paschou VP,Kontoyannis DA,Stamatelopoulos SF,Moulopoulos SD

    更新日期:1998-02-01 00:00:00

  • Assessment and significance of sarcopenia in liver transplantation.

    abstract::Sarcopenia frequently occurs in cirrhotic patients who are waiting for liver transplantation (LT). This disease is associated with increased morbidity and mortality rates during the LT period. Recently, the careful assessment of nutritional status for end-stage liver disease patients has received a great deal of atten...

    journal_title:Clinical transplantation

    pub_type: 杂志文章,评审

    doi:10.1111/ctr.13741

    authors: Nam NH,Kaido T,Uemoto S

    更新日期:2019-12-01 00:00:00

  • The profile of inflammatory and metabolic response in children undergoing heart transplantation.

    abstract::Inflammatory and metabolic response is an important factor to determine clinical outcomes. However, it remains unknown in children undergoing heart transplantation (HTx). We examined the perioperative changes in the inflammatory and metabolic response markers C-reactive protein (CRP) and prealbumin (PA) in 38 heart-tr...

    journal_title:Clinical transplantation

    pub_type: 杂志文章

    doi:10.1111/j.1399-0012.2011.01566.x

    authors: Yu X,Larsen B,Urschel S,Cheung PY,Ross DB,Rebeyka I,West L,Li J

    更新日期:2012-03-01 00:00:00

  • A call to action: Feasible strategies to reduce the discard of transplantable kidneys in the United States.

    abstract::Changes to the United States kidney allocation system targeted at reducing organ discard have failed to improve organ utilization. High Kidney Donor Profile Index kidneys continue to be discarded at high rates as a result of the regulatory and financial barriers to widespread utilization of these organs. However, ther...

    journal_title:Clinical transplantation

    pub_type: 杂志文章

    doi:10.1111/ctr.13990

    authors: Stewart ZA,Shah SA,Formica RN,Kandaswamy R,Paramesh AS,Friedman J,Squires R,Cooper M,Axelrod DA

    更新日期:2020-09-01 00:00:00

  • Retrograde arterial flush of the liver graft in living donor liver transplantation may ameliorate post-transplantational cholestasis--prospective randomized study.

    abstract::Retrograde arterial flush (RGAF) of liver grafts, which prevents arterial intima injuries in living donor liver transplantation (LDLT), seemed to reduce post-transplantational cholestasis by our preliminary study. The aim of this study was to further confirm this effect of RGAF of grafts in LDLT by a prospective rando...

    journal_title:Clinical transplantation

    pub_type: 杂志文章,随机对照试验

    doi:10.1111/j.1399-0012.2011.01493.x

    authors: Liu C,Loong CC,Hsia CY,Wang SC,Yeh YC,Lin NC,Tsai HL,Tsou MY

    更新日期:2012-03-01 00:00:00

  • Functional assessment of immune markers of graft rejection: a comprehensive study in live-related donor renal transplantation.

    abstract::A better understanding of the immunobiological processes and predictors of graft rejection holds promise for the development of potential therapeutic strategies and also individualization of immunosuppression. The objective of this study is to analyze the clinical relevance of immune parameters such as antidonor antih...

    journal_title:Clinical transplantation

    pub_type: 杂志文章

    doi:10.1111/j.1399-0012.2005.00445.x

    authors: Panigrahi A,Deka R,Bhowmik D,Dash SC,Tiwari SC,Guleria S,Mehta SN,Mehra NK

    更新日期:2006-01-01 00:00:00

  • Influence of immunosuppressive regimens on short-term morbidity and mortality in heart transplantation.

    abstract:BACKGROUND:The goal of immunosuppressive therapy in heart transplantation is to maximize safety and efficacy while minimizing morbidity and mortality. We now have numerous drug combinations, but few have been compared with each other. AIM:To compare various immunosuppressive regimens assessing morbidity and mortality ...

    journal_title:Clinical transplantation

    pub_type: 杂志文章

    doi:10.1111/j.1399-0012.2007.00751.x

    authors: Aguero J,Almenar L,Martínez-Dolz L,Moro JA,Rueda J,Raso R,Chamorro C,Sanchez JM,Salvador A

    更新日期:2008-01-01 00:00:00

  • Crystalloid flush with backward unclamping may decrease post-reperfusion cardiac arrest and improve short-term graft function when compared to portal blood flush with forward unclamping during liver transplantation.

    abstract::During liver transplant (LT), the release of vasoactive substances into the systemic circulation is associated with severe hemodynamic instability that is injurious to the recipient and/or the post-ischemic graft. Crystalloid flush with backward unclamping (CB) and portal blood flush with forward unclamping (PF) are t...

    journal_title:Clinical transplantation

    pub_type: 杂志文章

    doi:10.1111/ctr.12130

    authors: Fukazawa K,Nishida S,Hibi T,Pretto EA Jr

    更新日期:2013-07-01 00:00:00

  • Steroid withdrawal in pancreas transplant recipients.

    abstract:BACKGROUND:Numerous studies of steroid withdrawal have been carried out in kidney and liver transplant recipients, but only a few in pancreas transplant recipients. Yet, pancreas transplant recipients could have significant long-term benefits from steroid withdrawal. METHODS:We performed a retrospective analysis to de...

    journal_title:Clinical transplantation

    pub_type: 杂志文章

    doi:10.1034/j.1399-0012.2000.140114.x

    authors: Humar A,Parr E,Drangstveit MB,Kandaswamy R,Gruessner AC,Sutherland DE

    更新日期:2000-02-01 00:00:00

  • Pseudoaneurysm of the superior mesenteric artery with an arteriovenous fistula after simultaneous kidney-pancreas transplantation.

    abstract::Vascular complications remain a significant source of morbidity after pancreatic transplantation. We describe a pseudoaneurysm of the superior mesenteric artery (SMA) with an arteriovenous fistula (AVF) involving the SMA and the superior mesenteric vein (SMV) discovered and treated surgically in the second week after ...

    journal_title:Clinical transplantation

    pub_type: 杂志文章

    doi:10.1034/j.1399-0012.1999.130310.x

    authors: Khan TF,Ciancio G,Burke GW 3rd,Sfakianakis GN,Miller J

    更新日期:1999-06-01 00:00:00

  • Characteristics, risks, and outcomes of post-transplant lymphoproliferative disease >3 years after pediatric heart transplant: A multicenter analysis.

    abstract::Post-transplant lymphoproliferative disorder (PTLD) is a significant complication after pediatric heart transplantation (HT), occurring in 5%-15% of patients within 3 years. Data >3 years from HT are limited. We sought to describe the prevalence, risk factors, and outcomes of PTLD occurring late (>3 years) after pedia...

    journal_title:Clinical transplantation

    pub_type: 杂志文章,多中心研究

    doi:10.1111/ctr.13521

    authors: West SC,Friedland-Little JM,Schowengerdt KO Jr,Naftel DC,Pruitt Freeze E,Smith KS,Urschel S,Michaels MG,Kirklin JK,Feingold B

    更新日期:2019-05-01 00:00:00

  • Significance of serial real-time PCR monitoring of EBV genome load in living donor liver transplantation.

    abstract:BACKGROUND:Quantitative analysis of the Epstein-Barr virus (EBV) genome has been recently reported to be helpful for early identification of EBV viremia which could reduce the risk of post-transplantation lymphoproliferative disorder (PTLD). AIM:To demonstrate the significance of serial monitoring of EBV genome load b...

    journal_title:Clinical transplantation

    pub_type: 杂志文章

    doi:10.1034/j.1399-0012.2002.1o112.x

    authors: Matsukura T,Yokoi A,Egawa H,Kudo T,Kawashima M,Hirata Y,Tanaka H,Kagajo K,Wada H,Tanaka K

    更新日期:2002-04-01 00:00:00

  • Adverse symptoms of immunosuppressants: A survey of Canadian transplant clinicians.

    abstract::Adverse symptoms of immunosuppressants (ASI) impact quality of life (QOL) in solid organ transplant recipients; however, standardized approaches for active ASI surveillance and intervention are lacking. While management is highly clinician dependent, clinician views remain largely unexplored. We surveyed Canadian Soci...

    journal_title:Clinical transplantation

    pub_type: 杂志文章

    doi:10.1111/ctr.12940

    authors: Harrison JJ,Mansell H,Blydt-Hansen T

    更新日期:2017-05-01 00:00:00

  • Multidetector CT angiography in living donor renal transplantation: accuracy and discrepancies in right venous anatomy.

    abstract::Multidetector computed tomography (MDCT) angiography is a reliable technique for assessing pre-operative renal anatomy in living kidney donors. The method has largely evolved into protocols that eliminate dedicated venous phase and instead utilize a combined arterial/venous phase to delineate arterial and venous anato...

    journal_title:Clinical transplantation

    pub_type: 杂志文章

    doi:10.1111/j.1399-0012.2009.01193.x

    authors: Kulkarni S,Emre S,Arvelakis A,Asch W,Bia M,Formica R,Israel G

    更新日期:2011-01-01 00:00:00

  • Impact of gastrointestinal-related side effects on mycophenolate mofetil dosing and potential therapeutic strategies.

    abstract::In renal transplant patients receiving mycophenolate mofetil (MMF), maintaining an adequate dosing regimen has been shown to maximize short- and long-term outcomes. Gastrointestinal (GI) adverse events associated with MMF are frequent, and lead to MMF dose reduction or withdrawal in 40-50% of cases. Among MMF-treated ...

    journal_title:Clinical transplantation

    pub_type: 杂志文章,评审

    doi:10.1111/j.1399-0012.2008.00892.x

    authors: Bunnapradist S,Ambühl PM

    更新日期:2008-11-01 00:00:00

  • Effect of melphalan 140 mg/m(2) vs 200 mg/m(2) on toxicities and outcomes in multiple myeloma patients undergoing single autologous stem cell transplantation-a single center experience.

    abstract::Although melphalan at a dose of 140 mg/m(2) (MEL140) is an acceptable conditioning regimen for autologous stem cell transplantation (ASCT) in multiple myeloma (MM) patients, very few studies compared it to the most commonly used dose of 200 mg/m(2) (MEL200). A retrospective review of records of MM patients (2001-2010)...

    journal_title:Clinical transplantation

    pub_type: 杂志文章

    doi:10.1111/ctr.12762

    authors: Katragadda L,McCullough LM,Dai Y,Hsu J,Byrne M,Hiemenz J,May S,Cogle CR,Norkin M,Brown RA,Wingard JR,Chang M,Moreb JS

    更新日期:2016-08-01 00:00:00

  • Monitoring of cyclosporine levels in transplant recipients using self-administered fingerprick sampling.

    abstract::Use of C(2) monitoring for cyclosporine A (CsA) microemulsion results in improved clinical outcomes vs. trough (C(0)) monitoring. Logistical issues include accurate timing of the C(2) sample; requirement for sample dilution with most standard assay techniques; and inconvenience for patients. Recently, it has been show...

    journal_title:Clinical transplantation

    pub_type: 杂志文章

    doi:10.1111/j.1399-0012.2005.00472.x

    authors: Yonan N,Martyszczuk R,Machaal A,Baynes A,Keevil BG

    更新日期:2006-03-01 00:00:00

  • Impact of the ratio of graft kidney volume to recipient body surface area on graft function after live donor kidney transplantation.

    abstract::Functioning nephron mass is a determinant of the graft function of kidney transplant recipients. The graft kidney volume and its weight have been reported to be surrogates of the nephron mass. To investigate the impact of the ratios of the surrogates to recipient body surface area (BSA) and body weight on the graft fu...

    journal_title:Clinical transplantation

    pub_type: 杂志文章

    doi:10.1111/j.1399-0012.2011.01502.x

    authors: Lee JH,Won JH,Oh CK

    更新日期:2011-11-01 00:00:00

  • GORD symptoms in lung transplantation: how efficient is the reflux symptom index questionnaire compared to the esophageal impedance test?

    abstract:OBJECTIVE:As Gastroesophageal reflux disease (GORD) affects long-term survival in lung transplant recipients, the aim of this observational prospective study was to analyze the efficacy of The Reflux Symptom Index Questionnaire (RSI) compared to the esophageal impedance test. METHODS:Both esophageal impedance studies ...

    journal_title:Clinical transplantation

    pub_type: 杂志文章

    doi:10.1111/ctr.12656

    authors: Soresi S,Zeriouh M,Sabashnikov A,Mc Dermott G,Weymann A,Wippermann J,Wahlers T,Reed A,Carby M,Simon AR,Popov AF

    更新日期:2016-01-01 00:00:00

  • Renal transplant recipient attitudes toward steroid use and steroid withdrawal.

    abstract::Although steroid avoidance and withdrawal in renal transplant recipients (RTR) are actively being evaluated by physicians, the attitudes of recipients toward steroid use have not been systematically studied in the modern era. We conducted a confidential written survey of single-organ adult RTR pertaining to prednisone...

    journal_title:Clinical transplantation

    pub_type: 杂志文章

    doi:10.1034/j.1399-0012.2003.00034.x

    authors: Prasad GV,Nash MM,McFarlane PA,Zaltzman JS

    更新日期:2003-04-01 00:00:00

  • Heparin infusion in simultaneous pancreas and kidney transplantation reduces graft thrombosis and improves graft survival.

    abstract:INTRODUCTION:Thrombosis of the pancreas after transplantation is the most common cause of relaparotomy and resultant graft loss. There is currently no standard protocol consistently proven to prevent thrombosis following transplantation. Our objective was to determine whether our protocol of post-operative low-dose int...

    journal_title:Clinical transplantation

    pub_type: 杂志文章

    doi:10.1111/ctr.12780

    authors: Aboalsamh G,Anderson P,Al-Abbassi A,McAlister V,Luke PP,Sener A

    更新日期:2016-09-01 00:00:00