Abstract:
BACKGROUND:With the aim to improve the inferior outcomes in elderly recipients of kidneys from elderly cadaver donors, we applied and investigated a therapeutic regimen consisting of calcineurin inhibitor (CNI)-free, mycophenolate mofetil (MMF)-based immunosuppressive (i.s.) induction/maintenance protocol. In this article, we report the long-term results of this clinical trial. METHODS:A total of 89 recipients (mean age: 63.8 yr) of kidneys from cadaver donors (mean age: 66.8 yr) were consecutively recruited for this 5-yr, prospective, open, single centre, pilot trial. Induction therapy consisted of MMF and steroids in conjunction with a short course (4-10 d) of rabbit antithymocyte globulin (ATG). Maintenance treatment was performed with MMF/steroids or MMF alone under strict therapeutic drug monitoring by aiming target mycophenolic acid (MPA)-trough levels between 2 and 6 mg/mL. RESULTS:Cumulative 5-year patient and renal allograft survival was 87.69% and 69.81%, respectively. Acute rejection episodes occurred in 23.6% (21 patients). Long-term function of the old renal allografts proved to be satisfactory as reflected by serum creatinine-values of 1.53 mg/dL and urea-values of 57.9 mg/dL at 5 yr. CONCLUSION:Application of a nephrotoxicity- and atherogenicity-free, MMF-based i.s. induction/maintenance protocol in elderly recipient of kidneys from elderly cadaver donors leads to improved long-term outcomes which are comparable with data from young recipients who have received allografts from young cadaver donors.
journal_name
Clin Transplantjournal_title
Clinical transplantationauthors
Arbogast H,Hückelheim H,Schneeberger H,Illner WD,Tarabichi A,Fertmann J,Wimmer CD,Hillebrand GF,Mistry-Burchardi N,Thomae R,Acikgöz A,Land Wdoi
10.1111/j.1399-0012.2005.00309.xsubject
Has Abstractpub_date
2005-06-01 00:00:00pages
309-15issue
3eissn
0902-0063issn
1399-0012pii
CTR309journal_volume
19pub_type
临床试验,杂志文章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
更新日期:2013-07-01 00:00:00
abstract::We sought to determine the incidence, risk factors, and consequences of acute rejection (AR) after conversion from a calcineurin inhibitor (CNI) to a proliferation signal inhibitor (PSI) in maintenance heart transplantation. Relevant clinical data were retrospectively obtained for 284 long-term heart transplant recipi...
journal_title:Clinical transplantation
pub_type: 杂志文章,多中心研究
doi:10.1111/ctr.12241
更新日期:2013-11-01 00:00:00
abstract::Clinical outcomes are generally worse for black vs nonblack renal allograft recipients. In BENEFIT and BENEFIT-EXT, recipients were randomized to belatacept more intense-based, belatacept less intense-based, or cyclosporine-based immunosuppression. At year 7, belatacept was associated with superior graft survival vs c...
journal_title:Clinical transplantation
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1111/ctr.13225
更新日期:2018-04-01 00:00:00
abstract::Solid organ transplant recipients are at increased risk of developing several human papillomavirus (HPV)-related malignancies, including cervical and anal cancers. The purpose of this prospective study was to assess the initial prevalence and risk factors for high-risk HPV (HR-HPV) cervical infections in liver transpl...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/ctr.12894
更新日期:2017-03-01 00:00:00
abstract::The main cause of late morbidity and mortality after lung transplantation is bronchiolitis obliterans syndrome (BOS). This study assesses the prevalence of gastroparesis among lung-transplant recipients and its association with BOS. The files of 139 patients who underwent nuclear gastric emptying studies before and/or...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/j.1399-0012.2011.01434.x
更新日期:2012-01-01 00:00:00
abstract::This multicenter, randomized trial aimed to compare the safety and efficacy of an early reduction in corticosteroid dose vs. long-term maintenance in Brazilian patients on an immunosuppressive regimen based on tacrolimus and mycophenolate mofetil (MMF). In the control arm, prednisone was progressively reduced from day...
journal_title:Clinical transplantation
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1111/j.1399-0012.2009.01185.x
更新日期:2010-07-01 00:00:00
abstract::Kidney dysfunction is a recognized complication after non-renal solid organ transplantation, particularly after intestinal transplant. In our study, we reviewed data on 33 multivisceral transplant (MVT)- and 15 isolated small bowel (ISB)-transplant patients to determine risk factors for kidney dysfunction. Kidney func...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/j.1399-0012.2012.01672.x
更新日期:2012-07-01 00:00:00
abstract:BACKGROUND:Elderly patients are the fastest growing population requiring renal replacement therapy. As previous studies have shown a survival benefit of kidney transplantation compared to dialysis for end-stage renal disease, we sought to evaluate if this survival benefit extends to octogenarians. METHODS:This was a s...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/ctr.14074
更新日期:2020-11-01 00:00:00
abstract::The present AST-IDCOP guidelines update information on BK polyomavirus (BKPyV) infection, replication, and disease, which impact kidney transplantation (KT), but rarely non-kidney solid organ transplantation (SOT). As pretransplant risk factors in KT donors and recipients presently do not translate into clinically val...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/ctr.13528
更新日期:2019-09-01 00:00:00
abstract:BACKGROUND:Intraductal papillary mucinous neoplasms (IPMNs) of the pancreas are increasingly recognized in clinical practice. There are no published data suggesting a management approach for the potential organ transplant recipient with the incidental finding of this pre-malignant lesion. METHODS:The recipient was a 6...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/j.1399-0012.2008.00863.x
更新日期:2008-09-01 00:00:00
abstract:INTRODUCTION:Health-related quality of life (HRQOL) is severely impaired in advanced liver disease. The purpose of this study was to evaluate the impact of actual liver function and disease-specific factors on HRQOL of patients evaluated for liver transplantation. PATIENTS AND METHODS:Disease-specific QOL was analyzed...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/ctr.12426
更新日期:2014-12-01 00:00:00
abstract::The effect of HLA-DR3 gene expression was studied in black cadaveric renal allograft recipients of organs from the same donor race. From January 1984 to June 1992, 70 patients received cadaveric renal allografts at the Medical University of Southern Africa (MEDUNSA). The average age and F:M ratio was 30 years and 1: 1...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:
更新日期:1996-02-01 00:00:00
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
更新日期:2013-07-01 00:00:00
abstract::To examine the efficacy and safety of enteric-coated mycophenolate sodium (EC-MPS, myfortic) in renal transplant patients with diabetes mellitus, six- and 12-month data from three clinical trials with EC-MPS (Studies B301, B302, and myPROMS) were analyzed post hoc. Studies B301 (de novo patients) and B302 (maintenance...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/j.1399-0012.2006.00615.x
更新日期:2007-01-01 00:00:00
abstract::Obesity and weight gain are serious concerns after solid organ transplantation (Tx); however, no unbiased comparison regarding body weight parameter evolution across organ groups has yet been performed. Using data from the prospective nationwide Swiss Transplant Cohort Study, we compared the evolution of weight parame...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/ctr.12896
更新日期:2017-03-01 00:00:00
abstract::The development of post-transplant lymphoproliferative disorders (PTLD) is a well-recognized complication of solid organ transplantation in patients receiving immunosuppressive therapy. The literature on PTLD in live renal allograft recipients is scarce and most of the data pertains to PTLD in cadaveric transplants. A...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/j.1399-0012.2005.00406.x
更新日期:2005-10-01 00:00:00
abstract::Xenotransplantation is a potential strategy to overcome the shortage of human donor organs. As this technique has a major medical and psychological impact on patients and their family and friends, the attitude of patients currently waiting for organ transplantation is important. Therefore, we conducted a survey on the...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/j.1399-0012.2010.01296.x
更新日期:2011-05-01 00:00:00
abstract::Reducing acute care utilization is a means of improving long-term patient outcomes. We sought to assess high inpatient (IP) admission and standalone emergency department (ED) utilization within a 9-month period post-kidney transplantation and to identify mutable factors to reduce utilization. In this ten-year retrospe...
journal_title:Clinical transplantation
pub_type: 临床试验,杂志文章
doi:10.1111/ctr.13522
更新日期:2019-05-01 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::Steroid withdrawal has potential risks (rejection) and benefits (fewer complications). Most data on steroid-related complications predates cyclosporine (CsA). We tabulated the incidence of posttransplant complications considered to be steroid-related in 748 adult kidney transplant recipients (with at least 1 year of f...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:
更新日期:1994-06-01 00:00:00
abstract::Temporary portocaval shunt and total hepatectomy is a technique used in the presence of toxic liver syndrome because of fulminant hepatic failure, hepatic trauma, primary non-function (PNF), and eclampsia. We performed this technique on four patients. An indication for anhepatic state was severe hemodynamic instabilit...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/j.1399-0012.2009.01118.x
更新日期:2010-01-01 00:00:00
abstract::The aging of the on-dialysis population raises the issue of whether to propose elderly patients for kidney transplantation and how to manage their immunosuppression. This study aimed to analyze the outcome of kidney transplantation on an Italian series of elderly recipients. We included in this retrospective study all...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/ctr.13036
更新日期:2017-10-01 00:00:00
abstract:BACKGROUND:Tracheostomy is an important adjunct for lung transplant patients requiring prolonged ventilation. We explored the effects of post-transplant tracheostomy on survival and bronchiolitis obliterans syndrome after lung transplant. METHODS:A retrospective, single center analysis was performed on all lung transp...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/ctr.13766
更新日期:2020-01-01 00:00:00
abstract::Hepatitis C virus (HCV) is currently the leading indication worldwide for orthotopic liver transplantation. However, the majority of patients receiving transplant for HCV eventually develop histopathologic evidence of recurrent allograft HCV and approximately 10% die or require retransplantation within the first 5 pos...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1034/j.1399-0012.2003.00049.x
更新日期:2003-06-01 00:00:00
abstract:BACKGROUND:Liver ischaemia-reperfusion (I/R) occurs during resuscitation from haemorrhagic shock, hepatic transplantation and anatomic resection of the liver. This injury is associated with hepatocellular enzyme release and hepatocyte necrosis. The impact of chronic illnesses such as diabetes mellitus (DM) on hepatic I...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/j.1399-0012.2004.00210
更新日期:2004-01-01 00:00:00
abstract:INTRODUCTION:Totally implantable venous access devices (TIVADs) are the preferred devices for patients with advanced lung disease who require long-term venous access. The primary purpose of this study was to describe the natural history of TIVADs left in place at the time of transplant. METHODS:This multicenter retros...
journal_title:Clinical transplantation
pub_type: 杂志文章,多中心研究
doi:10.1111/ctr.13465
更新日期:2019-02-01 00:00:00
abstract::The organ shortage is one of the major challenges in the field of organ transplantation, yet the percentage of kidneys procured and discarded prior to transplantation has continued to rise to twenty percent. The causes of organ discard are complex, yet an urgent need exists for collaborative efforts to maximize the ut...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/ctr.13419
更新日期:2019-01-01 00:00:00
abstract::In the general population, obesity is associated with an increased risk of developing hypertension (HTN), type 2 diabetes mellitus (DM), and end-stage renal disease (ESRD). Therefore, most transplant centers have a body mass index (BMI) threshold for accepting living kidney donors. But there have been no studies of po...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/ctr.13360
更新日期:2018-09-01 00:00:00
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
更新日期:2006-01-01 00:00:00
abstract:INTRODUCTION:The average age of patients undergoing liver transplantation (LT) is consistently increasing. The aim of this case-control study is to evaluate survival and outcome of patients ≥65 yr compared to younger patients undergoing LT. MATERIALS AND METHODS:From 10/00 to 4/08 we performed 330 primary LT, 31 (9.4%...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/j.1399-0012.2010.01230.x
更新日期:2010-09-01 00:00:00