Abstract:
BACKGROUND:The clinical consequences of type 1 diabetes mellitus (IDDM) include diabetic triopathy: retinopathy, nephropathy, and neuropathy, as well as microangiopathy, accelerated atherosclerotic disease, and hypercoagulability. The etiology of the hypercoagulability is multifactorial, involving various clotting factors or pathways (for example platelets, fibrinogen, individual components of the clotting system and/or fibrinolysis in different studies). The development of end-stage renal disease (ESRD), with the uremia-related platelet effect has the potential to protect from the existing hypercoagulable state. This has important implications for surgery, particularly simultaneous pancreas-kidney (SPK) transplantation, where the pancreas has historically been prone to thrombosis. This has led us to perform intra-operative thromboelastograms (TEG's) to evaluate the patient's current coagulation status. METHODS:A TEG was performed in 85 SPK recipients along with a control group of 54 non-diabetic kidney transplant (KT) recipients. RESULTS:For each of the 4 TEG coagulation parameters, the SPK recipients were significantly more hypercoagulable than the non-diabetic KT recipients. The use of intra-operative heparin is based on the degree of hypercoagulability by TEG and degree of operative hemostasis. There has been one PT lost to thrombosis (1%) in the first week following transplantation during this time. CONCLUSION:The use of TEG is a helpful adjunct to SPK surgery, demonstrating the patient's current coagulation status. Nearly all SPK recipients (type 1 IDDM with ESRD) have been demonstrated to be hypercoagulable. The TEG allows the judicious use of anti-coagulation at the time of surgery, and beyond.
journal_name
Clin Transplantjournal_title
Clinical transplantationauthors
Burke GW 3rd,Ciancio G,Figueiro J,Buigas R,Olson L,Roth D,Kupin W,Miller Jdoi
10.1111/j.1399-0012.2004.00183.xsubject
Has Abstractpub_date
2004-08-01 00:00:00pages
423-8issue
4eissn
0902-0063issn
1399-0012pii
CTR183journal_volume
18pub_type
杂志文章abstract::The amount of irreversible injury on renal allograft biopsy predicts function, but little is known about the early evolution of this damage. In a single-center cohort, we examined the relationship between donor-, recipient-, and transplantation-associated factors and change in a morphometric index of chronic damage (I...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/ctr.12251
更新日期:2013-11-01 00:00:00
abstract::Angiotensin-converting enzyme inhibitor (ACEI) has become recognized as agents that have renoprotective effects in the treatment of progressive renal diseases including post-transplant kidneys. Previously we demonstrated the safety and effectiveness of ACEI treatment on the hypertensive proteinuric post-transplant pat...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/j.1399-0012.2004.00244.x
更新日期:2004-01-01 00:00:00
abstract:BACKGROUND:Our objective is to evaluate whether hyperglycemia in the first 48 h after renal transplantation is independently associated with rejection, post-operative infection and post-transplant diabetes mellitus (PTDM) in a retrospective cohort study. METHODS:Patients who received a renal transplant in our hospital...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/j.1399-0012.2008.00910.x
更新日期:2009-03-01 00:00:00
abstract::Whole pancreas and islet cell transplantation are both reliant upon the procurement and preservation of a high quality donor pancreas for a successful outcome. In the climate of a reducing donor pool it is imperative that donor optimization, meticulous surgical retrieval and evidence based methods of preservation are ...
journal_title:Clinical transplantation
pub_type: 杂志文章,评审
doi:10.1111/j.1399-0012.2009.01151.x
更新日期:2010-01-01 00:00:00
abstract::A total of 123 consecutive patients with advanced-stage, acute leukemia undergoing HSCT from HLA-identical sibling donors were analyzed. A G-CSF-primed DLI was planned within day 60 post-transplantation before hematologic relapse was diagnosed. Fifty of the 123 individuals received prophylactic DLI, and 73 individuals...
journal_title:Clinical transplantation
pub_type: 杂志文章,多中心研究
doi:10.1111/j.1399-0012.2012.01626.x
更新日期:2012-07-01 00:00:00
abstract::Acute allograft rejection in patients after cardiac transplantation is associated with intense infiltration of inflammatory cells. It has been shown in animal studies that this inflammatory process is accompanied by an induction of nitric oxide syndrome (NOS) enzyme within the grafted organ. We sought to test the hypo...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:
更新日期:1996-06-01 00:00:00
abstract::Ten-year protocol biopsies were performed in 16 patients treated with calcineurin inhibitor (CNI) continuously. All kidney grafts were functioning well at the time of biopsy with the mean serum creatinine level of 1.6 +/- 0.8 mg/dL. The specimen of biopsy showed various degrees of tissue injury. According to the Banff...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/j.1399-0012.2006.00544.x
更新日期:2006-01-01 00:00:00
abstract:BACKGROUND:We examined the risk of adverse pregnancy outcomes in primiparous kidney donors compared to matched controls. METHODS:Fifty-nine women with a history of kidney donation prior to their first pregnancy with normal renal function and no history of kidney disease, diabetes or chronic hypertension were matched 1...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/ctr.13453
更新日期:2019-01-01 00:00:00
abstract:BACKGROUND:Pharmacologic stress testing is utilized in preference to exercise stress echocardiography (ESE) for cardiac risk evaluation in potential renal transplant recipients due to the perceived lower feasibility of ESE for achieving adequate workload and target heart rate (THR) in this population. METHODS:Consecut...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/ctr.12796
更新日期:2016-10-01 00:00:00
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journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/ctr.12806
更新日期:2016-10-01 00:00:00
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journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1034/j.1399-0012.2002.01121.x
更新日期:2002-06-01 00:00:00
abstract:AIM:Uncontrolled donation after cardiac death (uDCD) remains an underutilized source of kidney allografts in the United States. The objective of this study was to estimate the impact of the implementation of a uDCD program on transplantation rates and long-term survival for patients with end-stage renal disease (ESRD) ...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/ctr.13868
更新日期:2020-07-01 00:00:00
abstract::Temporary graft dysfunction with gas exchange abnormalities is a common finding during the postoperative course of a lung transplant and is often determined by the post-reimplantation syndrome. Supportive measures including oxygen by mask, inotropes, diuretics, and pulmonary vasodilators are usually effective in non-s...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/j.1399-0012.2009.01050.x
更新日期:2009-09-01 00:00:00
abstract::In this single-institution study, we compared outcomes in diabetic recipients of living donor (LD) kidney transplants that did vs. did not undergo a subsequent pancreas transplant. Of 307 diabetic recipients who underwent LD kidney transplants from January 1, 1995, through December 31, 2003, a total of 175 underwent a...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/j.1399-0012.2009.00998.x
更新日期:2009-08-01 00:00:00
abstract:INTRODUCTION:We examined the effect of haemodialysis (HD) or peritoneal dialysis (PD) on acute rejection, delayed graft function (DGF), graft and patient survival after cadaveric renal transplantation. MATERIALS AND METHODS:We carried out a retrospective analysis of 325 patients (cyclosporin [CyA]-based therapy) who h...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1034/j.1399-0012.2002.00069.x
更新日期:2002-02-01 00:00:00
abstract:BACKGROUND:Relationships between race/ethnicity, recipient medical insurance, and living donor kidney transplantation (LKT) are incompletely described. METHODS:Associations between medical insurance and LKT were assessed in 447 recipients at a southeastern US transplant center. Primary and secondary payers were includ...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/ctr.12168
更新日期:2013-07-01 00:00:00
abstract::Haploidentical stem cell transplantation (SCT) is increasingly used to treat pediatric patients with malignant or nonmalignant hematological disorders. The CD34+ dose of bone marrow or peripheral blood stem cells (PBSCs) has been shown to be an important determinant of the transplant outcome in adults under various pr...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/ctr.12880
更新日期:2017-02-01 00:00:00
abstract::We analyzed the influence on allograft survival of pretransplant panel reactive antibodies (PRA) < 10%, PRA > 10%, autoantibodies, cold antibodies and a positive B cell crossmatch in 807 renal and 237 cardiac transplant recipients. Donors and recipients were predominantly of mixed ancestry (Khoi, San, Xhosa and Caucas...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:
更新日期:1997-04-01 00:00:00
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:
更新日期:1997-08-01 00:00:00
abstract:BACKGROUND/OBJECTIVES:Vascular thrombosis is the most common cause of early graft loss after transplantation. Routine grayscale and Doppler ultrasound frequently fail to adequately visualize vascular compromise. Contrast-enhanced ultrasound is a novel approach to identifying these complications. METHODS:This was a pro...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/ctr.13733
更新日期:2019-12-01 00:00:00
abstract::Early measures of graft function are increasingly used to assess efficacy in clinical trials of kidney transplant immunosuppression. This study aimed to assess the variability and quality of reporting of these endpoints in contemporary trials. Data regarding renal function endpoints were extracted from 213 reports fro...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/ctr.12861
更新日期:2016-12-01 00:00:00
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...
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pub_type: 杂志文章,评审
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更新日期:2019-12-01 00:00:00
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journal_title:Clinical transplantation
pub_type: 杂志文章
doi:
更新日期:1996-12-01 00:00:00
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journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/ctr.13406
更新日期:2018-11-01 00:00:00
abstract::As many as 50% of liver transplant patients suffer gastrointestinal (GI) disturbances post-transplant. Conversion from mycophenolate mofetil (MMF) to mycophenolate sodium (EC-MPS) alleviates GI symptom burden in renal transplant recipients. We employed a validated patient and physician-reported assessment to evaluate ...
journal_title:Clinical transplantation
pub_type: 临床试验,杂志文章
doi:10.1111/j.1399-0012.2011.01444.x
更新日期:2012-01-01 00:00:00
abstract:INTRODUCTION:The impact of induction immunosuppression on long-term survival in lung transplant recipients remains unclear. We sought to evaluate the effect of contemporary induction immunosuppression agents in lung transplant recipients' survival, utilizing national registry data. METHODS:We queried the United Networ...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/ctr.12339
更新日期:2014-04-01 00:00:00
abstract:BACKGROUND:End-stage renal disease is associated with illness-induced disruptions that challenge patients and their families to accommodate and adapt. However, the impact of patients' marital status on kidney transplant outcome has never been studied. This project, based on data from United States Renal Data System (US...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/j.1399-0012.2006.00575.x
更新日期:2007-01-01 00:00:00
abstract::These updated guidelines from the American Society of Transplantation Infectious Diseases Community of Practice provide recommendations for the diagnosis and management of Candida infections in solid organ transplant recipients. Candida infections manifest primarily as candidemia and invasive candidiasis and cause con...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/ctr.13623
更新日期:2019-09-01 00:00:00
abstract::We report of twins who underwent hematopoietic stem cell transplantation (HSCT) for neonatal acute leukemia. Hospitalized in the same room from the time the first one demonstrated respiratory symptoms, they both developed Pneumocystis jiroveci (formerly carinii) pneumonia (PCP) 2 wk apart. This observation suggests th...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/j.1399-0012.2005.00346.x
更新日期:2005-06-01 00:00:00
abstract::Renal allograft recipients with thrombophilic (hypercoagulable) states are at higher risk for early allograft loss. Presumably, the combination of endothelial injury at surgery and thrombophilia predisposes to arterial or venous thrombosis. Of 270 consecutive renal transplants at our center one allograft failed second...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1034/j.1399-0012.2002.02006.x
更新日期:2002-08-01 00:00:00