Ten-year experience with cyclosporine as primary immunosuppression in recipients of renal allografts.

Abstract:

:Cyclosporine has been used as primary immunosuppression in renal allograft recipients in our unit for the past decade. The overall clinical experience and long-term effects of the agent are reviewed. There were 461 consecutive recipients of kidney grafts; 379 received grafts from cadaver donors (CAD) and 82 from living related donors (LRD). Four separate clinical protocols were used sequentially using progressively decreasing doses of CyA; azathioprine was added in group 4 recipients of LRD grafts, and in patients receiving secondary CAD grafts (group 5). The patient mortality rate was less than 5%, with sepsis being the prime contributor. The majority of kidney grafts were lost within the first 2 months after operation; those that never functioned were found almost invariably to have been irreversibly rejected. During the subsequent years of follow-up, attrition of CAD grafts was significantly greater than LRD grafts. In contrast, the attrition rate of primary and secondary CAD grafts was the same after the first 3 months, emphasizing the importance of early immunologic graft destruction. Primary nonfunction occurred in 49% of CAD kidneys and 17% of LRD grafts; however 71% of initially nonfunctioning LRD grafts never functioned at all compared to 34% of CAD grafts, the majority of such organs undergoing fulminate rejection. Individual graft loss after 1 year was almost inevitably due to chronic rejection; there were no differences in long-term allograft function among the treatment groups. Although CyA has improved overall results of kidney transplantation, chronic rejection remains a major unresolved problem.

journal_name

Ann Surg

journal_title

Annals of surgery

authors

Tilney NL,Chang A,Milford EL,Whitley WD,Lazarus JM,Ramos EL,Strom TB,Carpenter CB,Kirkman RL

doi

10.1097/00000658-199107000-00007

subject

Has Abstract

pub_date

1991-07-01 00:00:00

pages

42-9

issue

1

eissn

0003-4932

issn

1528-1140

journal_volume

214

pub_type

杂志文章
  • Adult living donor liver transplantation for patients with hepatocellular carcinoma: extending UNOS priority criteria.

    abstract:INTRODUCTION:For patients with hepatocellular carcinoma (HCC) in particular, living donor liver transplant (LDLT) improves access to transplant. We report our results in 36 patients with HCC who underwent LDLT with a median follow-up >1 year. METHODS Underlying diagnoses included: hepatitis C (24), hepatitis B (9), cry...

    journal_title:Annals of surgery

    pub_type: 评论,杂志文章

    doi:10.1097/01.sla.0000109022.32391.eb

    authors: Gondolesi GE,Roayaie S,Muñoz L,Kim-Schluger L,Schiano T,Fishbein TM,Emre S,Miller CM,Schwartz ME

    更新日期:2004-02-01 00:00:00

  • Mental Skills in Surgery: Lessons Learned from Virtuosos, Olympians, and Navy Seals.

    abstract:OBJECTIVE:The present study investigated the role of mental skills in surgery through the unique lens of current surgeons who had previously served as Olympic athletes, elite musicians, or expert military personnel. BACKGROUND:Recent work has demonstrated great potential for mental skills training in surgery. However,...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/SLA.0000000000003573

    authors: Deshauer S,McQueen S,Hammond Mobilio M,Mutabdzic D,Moulton CE

    更新日期:2019-08-28 00:00:00

  • New technique for liver resection using heat coagulative necrosis.

    abstract:OBJECTIVE:To assess a new bloodless technique using radiofrequency energy for segmental liver resection of hepatic tumors. SUMMARY BACKGROUND DATA:Liver resection remains a formidable surgical procedure; safe performance requires a high level of training and skill. Intraoperative blood loss during liver resection rema...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/00000658-200211000-00004

    authors: Weber JC,Navarra G,Jiao LR,Nicholls JP,Jensen SL,Habib NA

    更新日期:2002-11-01 00:00:00

  • The comparative effectiveness of surgeons over interventionalists in endovascular repairs of abdominal aortic aneurysm.

    abstract:OBJECTIVE:Comparative effectiveness research has mostly been focused on comparison of treatment techniques. The goal of the present study was to extend the research to physician specialty. BACKGROUND:Both surgeons and interventionalists (cardiologists and radiologists) are involved in endovascular repairs (EVAR) of ao...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/SLA.0b013e3182a196b5

    authors: McCutcheon BA,Talamini MA,Chang DC,Rose JA,Bandyk DF,Wilson SE

    更新日期:2013-09-01 00:00:00

  • The impact of neural invasion severity in gastrointestinal malignancies: a clinicopathological study.

    abstract:OBJECTIVES:Because neural invasion (NI) is still inconsistently reported and not well characterized within gastrointestinal malignancies (GIMs), our aim was to determine the exact prevalence and severity of NI and to elucidate the true impact of NI on patient's prognosis. BACKGROUND:The union internationale contre le ...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/SLA.0000000000000968

    authors: Liebl F,Demir IE,Mayer K,Schuster T,DʼHaese JG,Becker K,Langer R,Bergmann F,Wang K,Rosenberg R,Novotny AR,Feith M,Reim D,Friess H,Ceyhan GO

    更新日期:2014-11-01 00:00:00

  • Endovascular stent graft repair of abdominal and thoracic aortic aneurysms: a ten-year experience with 817 patients.

    abstract:OBJECTIVE:On November 23, 1992, the first endovascular stent graft (ESG) repair of an aortic aneurysm was performed in North America. Following the treatment of this patient, we have continued to evaluate ESG over the past 10 years in the treatment of 817 patients. SUMMARY AND BACKGROUND DATA:Abdominal (AAA) or thorac...

    journal_title:Annals of surgery

    pub_type: 杂志文章,多中心研究

    doi:10.1097/01.sla.0000090473.63393.e9

    authors: Marin ML,Hollier LH,Ellozy SH,Spielvogel D,Mitty H,Griepp R,Lookstein RA,Carroccio A,Morrissey NJ,Teodorescu VJ,Jacobs TS,Minor ME,Sheahan CM,Chae K,Oak J,Cha A

    更新日期:2003-10-01 00:00:00

  • Oxygen as an isolated variable influences resistance to infection.

    abstract::The relative importance of oxygen in relation to resistance to infection was assessed in 24 mongrel dogs. Rectus abdominis musculocutaneous (MC) and corresponding cutaneous random pattern (RP) flaps based at the level of the xiphoid were elevated, replaced, and sutured. Immediately after the surgical procedure, 0.1 ml...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/00000658-198812000-00018

    authors: Jönsson K,Hunt TK,Mathes SJ

    更新日期:1988-12-01 00:00:00

  • A rational approach to surgery of the chronic venous statis syndrome.

    abstract::Ambulatory venous pressure (AVP) and ascending and retro-grade phlebography have been used to elucidate the precise pathogenetic factors in cases of venous stasis. On the bases of this information, procedures aimed at the correction of the particular pathophysiological alterations were carried out. Fifty-two lower ext...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/00000658-198201001-00004

    authors: Schanzer H,Peirce EC 2nd

    更新日期:1982-01-01 00:00:00

  • A systematic study of host defense processes in badly injured patients.

    abstract::A prospective study of factors predisposing to infection in badly injured patients has disclosed: the dominant roles of two specific parameters: monocyte antigen presenting capacity, and opsonic capacity of diluted serum; the potential value of further assessment of: the predictive value of plots of activated T-cells/...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:

    authors: Polk HC Jr,George CD,Wellhausen SR,Cost K,Davidson PR,Regan MP,Borzotta AP

    更新日期:1986-09-01 00:00:00

  • The role of tumor necrosis factor and nitric oxide in the acute cardiovascular response to endotoxin.

    abstract:OBJECTIVE:This study was designed to examine the differential effects of tumor necrosis factor (TNF) and nitric oxide on the acute cardiovascular changes that occur in response to endotoxemia. SUMMARY BACKGROUND DATA:Recent studies have suggested that some, if not all, of the cardiovascular effects of TNF are mediated...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/00000658-199601000-00009

    authors: Fahey TJ 3rd,Yoshioka T,Shires GT,Fantini GA

    更新日期:1996-01-01 00:00:00

  • Bronchopulmonary foregut malformations. The spectrum of anomalies.

    abstract::Ventral anomalies of accessory pulmonary tissue have been classified as "bronchopulmonary foregut malformations." Between July 1, 1981, and May 31, 1985, 10 children with bronchopulmonary malformations have been cared for on the Pediatric Surgical Service at the University of Virginia. Six patients had bronchogenic cy...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/00000658-198605000-00011

    authors: Rodgers BM,Harman PK,Johnson AM

    更新日期:1986-05-01 00:00:00

  • Decreased surgical risks of pancreas transplantation in the modern era.

    abstract:OBJECTIVE:To document the decreased incidence of surgical complications after pancreas transplantation in recent times. SUMMARY BACKGROUND DATA:Compared with other abdominal transplants, pancreas transplants have historically had the highest incidence of surgical complications. However, over the past few years, the au...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/00000658-200002000-00017

    authors: Humar A,Kandaswamy R,Granger D,Gruessner RW,Gruessner AC,Sutherland DE

    更新日期:2000-02-01 00:00:00

  • Metastatic Potential and Survival of Duodenal and Pancreatic Tumors in Multiple Endocrine Neoplasia Type 1: A GTE and AFCE Cohort Study (Groupe d'étude des Tumeurs Endocrines and Association Francophone de Chirurgie Endocrinienne).

    abstract:OBJECTIVE:To assess the distant metastatic potential of duodeno-pancreatic neuroendocrine tumors (DP-NETs) in patients with MEN1, according to functional status and size. SUMMARY BACKGROUND DATA:DP-NETs, with their numerous lesions and endocrine secretion-related symptoms, continue to be a medical challenge; unfortuna...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/SLA.0000000000003162

    authors: Vinault S,Mariet AS,Le Bras M,Mirallié E,Cardot-Bauters C,Pattou F,Ruszniewski P,Sauvanet A,Chanson P,Baudin E,Elias D,Menegaux F,Gaujoux S,Borson-Chazot F,Lifante JC,Caron P,Carrère N,Tabarin A,Laurent C,Klein M,

    更新日期:2020-12-01 00:00:00

  • Nutritional consequences of total gastrectomy.

    abstract::Nutritional status was investigated in 10 patients who had previously undergone total gastrectomy without evidence of malignancy. The ability of these patients to ingest and absorb adequate amounts of nutrients was examined. Metabolic balance studies were also performed to discover how effectively these patients coul...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/00000658-197510000-00007

    authors: Bradley EL 3rd,Isaacs J,Hersh T,Davidson ED,Millikan W

    更新日期:1975-10-01 00:00:00

  • Inhalation injury severity and systemic immune perturbations in burned adults.

    abstract:OBJECTIVE:We aimed to determine whether the severity of inhalation injury evokes an immune response measurable at the systemic level and to further characterize the balance of systemic pro- and anti-inflammation early after burn and inhalation injury. BACKGROUND:Previously, we reported that the pulmonary inflammatory ...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/SLA.0b013e318275f424

    authors: Davis CS,Janus SE,Mosier MJ,Carter SR,Gibbs JT,Ramirez L,Gamelli RL,Kovacs EJ

    更新日期:2013-06-01 00:00:00

  • Cost-effectiveness of Enhanced Recovery Versus Conventional Perioperative Management for Colorectal Surgery.

    abstract:OBJECTIVE:To determine the cost-effectiveness of enhanced recovery pathways (ERPs) versus conventional care for patients undergoing elective colorectal surgery. BACKGROUND:ERPs for colorectal surgery are clinically effective, but their cost-effectiveness is unknown. METHODS:A multi-institutional prospective cohort co...

    journal_title:Annals of surgery

    pub_type: 临床试验,杂志文章,多中心研究

    doi:10.1097/SLA.0000000000001019

    authors: Lee L,Mata J,Ghitulescu GA,Boutros M,Charlebois P,Stein B,Liberman AS,Fried GM,Morin N,Carli F,Latimer E,Feldman LS

    更新日期:2015-12-01 00:00:00

  • Specialty networking in pediatric surgery: a paradigm for the future of academic surgery.

    abstract:OBJECTIVE:To review retrospectively a 4-year experience with pediatric surgical networking at a major academic medical center in the Midwest. BACKGROUND:The growth of managed care in the United States during the past decade has had a major impact on the practice of medicine in general, but especially on academic medic...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/00000658-199909000-00006

    authors: Coran AG,Blackman PM,Sikina C,Harmon CM,Lelli JL Jr,Geiger JD,Hirschl RB,Teitelbaum DH,Polley TZ Jr,Golladay ES,Austin E,Adelman SH

    更新日期:1999-09-01 00:00:00

  • A prospective study of thymectomy and serum acetylcholine receptor antibodies in myasthenia gravis.

    abstract::Forty-seven consecutively presenting myasthenia gravis (MG) patients with generalized weakness were treated according to a standardized prospective protocol. All patients underwent a sternal splitting "total" thymectomy. Medical status before surgery was optimized by plasmapheresis without immunosuppression. Medicatio...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/00000658-198208000-00001

    authors: Olanow CW,Wechsler AS,Roses AD

    更新日期:1982-08-01 00:00:00

  • Expression of the neurotensin gene in fetal human liver and fibrolamellar carcinoma.

    abstract:OBJECTIVE:This study determined whether the neurotensin gene (NT/N) is expressed in the normal adult liver and focal nodular hyperplasia (FNH) and confirmed NT/N expression in fibrolamellar carcinoma; whether NT/N or the neurotensin receptor is expressed in the fetal liver; and whether hepatic resection leads to expres...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/00000658-199410000-00007

    authors: Ehrenfried JA,Zhou Z,Thompson JC,Evers BM

    更新日期:1994-10-01 00:00:00

  • Controlled clinical trial of selective decontamination for the treatment of severe acute pancreatitis.

    abstract:OBJECTIVE:A randomized, controlled, multicenter trial was undertaken in 102 patients with objective evidence of severe acute pancreatitis to evaluate whether selective decontamination reduces mortality. SUMMARY BACKGROUND DATA:Secondary pancreatic infection is the major cause of death in patients with acute necrotizin...

    journal_title:Annals of surgery

    pub_type: 临床试验,杂志文章,多中心研究,随机对照试验

    doi:10.1097/00000658-199507000-00010

    authors: Luiten EJ,Hop WC,Lange JF,Bruining HA

    更新日期:1995-07-01 00:00:00

  • Single-port donor nephrectomy provides improved patient satisfaction and equivalent outcomes.

    abstract:OBJECTIVE:Minimally invasive techniques have expanded the donor pool for living kidney donation. We changed our approach to single-port donor nephrectomy in 2009 and have compared outcomes with traditional multiple-port laparoscopic donor nephrectomy. BACKGROUND:The development of minimally invasive surgical technique...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/SLA.0b013e318262ddd6

    authors: Barth RN,Phelan MW,Goldschen L,Munivenkatappa RB,Jacobs SC,Bartlett ST,Philosophe B

    更新日期:2013-03-01 00:00:00

  • A Study of Clinical Coding Accuracy in Surgery: Implications for the Use of Administrative Big Data for Outcomes Management.

    abstract:BACKGROUND:Clinical coding is the translation of clinical activity into a coded language. Coded data drive hospital reimbursement and are used for audit and research, and benchmarking and outcomes management purposes. METHODS:We undertook a 2-center audit of coding accuracy across surgery. Clinician-auditor multidisci...

    journal_title:Annals of surgery

    pub_type: 杂志文章,多中心研究

    doi:10.1097/SLA.0000000000000851

    authors: Nouraei SA,Hudovsky A,Frampton AE,Mufti U,White NB,Wathen CG,Sandhu GS,Darzi A

    更新日期:2015-06-01 00:00:00

  • An aggressive surgical approach leads to improved survival in patients with gallbladder cancer: a 12-year study at a North American Center.

    abstract:OBJECTIVE:To determine if an aggressive surgical approach, with an increase in R0 resections, has resulted in improved survival for patients with gallbladder cancer. SUMMARY BACKGROUND DATA:Many physicians express a relatively nihilistic approach to the treatment of gallbladder cancer; consensus among surgeons regardi...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/01.sla.0000154118.07704.ef

    authors: Dixon E,Vollmer CM Jr,Sahajpal A,Cattral M,Grant D,Doig C,Hemming A,Taylor B,Langer B,Greig P,Gallinger S

    更新日期:2005-03-01 00:00:00

  • Restoration of normal distensive characteristics of the esophagogastric junction after fundoplication.

    abstract:OBJECTIVE:To study the mechanical characteristics of the esophagogastric junction (EGJ) of postfundoplication patients and compare them with previously reported data on normal subjects and GERD patients. METHODS:Eight normal subjects, 9 GERD patients, and 8 fundoplication patients were studied with concurrent manometr...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/01.sla.0000167868.44211.f0

    authors: Pandolfino JE,Curry J,Shi G,Joehl RJ,Brasseur JG,Kahrilas PJ

    更新日期:2005-07-01 00:00:00

  • A kinetic study of leucine metabolism in severely burned patients. Comparison between a conventional and branched-chain amino acid-enriched nutritional therapy.

    abstract::A cross-over design study was used to examine the metabolic consequences of enteral feeding for 48 to 96 hours with either a branched-chain amino acid (BCAA)-enriched (44% BCAA) or a conventional egg protein formulation in 12 severely burned adult patients. A stable isotope labeled leucine (L-1-13C-leucine) tracer app...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/00000658-198804000-00009

    authors: Yu YM,Wagner DA,Walesreswski JC,Burke JF,Young VR

    更新日期:1988-04-01 00:00:00

  • Submaximal exercise during intravenous hyperalimentation of depleted subjects.

    abstract::The peripheral nitrogen wasting and loss of functional capacity caused by the malnutrition of disease and the immobilization of hospitalization may not be readily reversed by refeeding alone. In order to examine submaximal exercise as an adjunctive anabolic stimulus to intravenous refeeding (IVF) in depleted subjects,...

    journal_title:Annals of surgery

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1097/00000658-198803000-00012

    authors: Fong Y,Hesse DG,Tracey KJ,Albert JD,Legaspi A,Brennan MF,Lowry SF

    更新日期:1988-03-01 00:00:00

  • The Linton splenorenal shunt in the management of the bleeding complications of portal hypertension.

    abstract::This report describes 140 cases in which Linton splenorenal shunts were performed for the management of the complications of portal hypertension by a large number of surgeons in a single hospital. There was a history of variceal bleeding in 130. Using the Childs designation to reflect hepatic functional reserve, the o...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/00000658-198212001-00008

    authors: Ottinger LW

    更新日期:1982-12-01 00:00:00

  • Case managers in mass casualty incidents.

    abstract:OBJECTIVE:To examine whether case managers affect patient evaluation/treatment/outcome and staffing requirements during Multiple Casualty Incidents (MCIs). SUMMARY BACKGROUND DATA:Multiple patient relocations during MCIs may contribute to chaos. One hospital changed its MCI patient relocation policy during a wave of M...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/SLA.0b013e31819a6f17

    authors: Einav S,Schecter WP,Matot I,Horn JK,Hersch M,Reissman P,Spira RM

    更新日期:2009-03-01 00:00:00

  • NF-kappaB activation in esophageal adenocarcinoma: relationship to Barrett's metaplasia, survival, and response to neoadjuvant chemoradiotherapy.

    abstract:OBJECTIVE:To examine the expression of the transcription factor nuclear factor kappa B (NF-kappaB) in Barrett's epithelium and adenocarcinoma and the impact of NF-kappaB expression on tumor stage and response to neoadjuvant chemotherapy and radiation therapy. SUMMARY BACKGROUND DATA:Progression of Barrett's esophagus ...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/01.sla.0000118751.95179.c6

    authors: Abdel-Latif MM,O'Riordan J,Windle HJ,Carton E,Ravi N,Kelleher D,Reynolds JV

    更新日期:2004-04-01 00:00:00

  • End-to-end versus end-to-side esophagogastrostomy after esophageal cancer resection: a prospective randomized study.

    abstract:OBJECTIVE:To compare single-layered hand-sewn cervical end-to-side (ETS) anastomosis with end-to-end (ETE) anastomosis in a prospective randomized fashion. BACKGROUND:The preferred organ used for reconstruction after esophagectomy for cancer is the stomach. Previous studies attempted to define the optimal site of anas...

    journal_title:Annals of surgery

    pub_type: 杂志文章,随机对照试验

    doi:10.1097/SLA.0b013e31822676a9

    authors: Nederlof N,Tilanus HW,Tran TC,Hop WC,Wijnhoven BP,de Jonge J

    更新日期:2011-08-01 00:00:00