Abstract:
BACKGROUND:The use of kidneys from non-heartbeating donors (NHB) remains controversial. An increased incidence of delayed primary function and primary nonfunction is common. We report a characteristic syndrome of transaminitis and thrombocytopenia after NHB renal transplantation, which may be predictive of graft outcome. METHODS:Two case histories are presented, followed by a retrospective analysis of 38 NHB renal grafts performed at Guy's Hospital from 1988 to 1994. Changes in alanine aminotransferase (ALT) and platelet count were compared between recipients of kidneys from NHB and heartbeating donors (HB). To control for possible effects of antilymphocyte globulin (ALG), two matched control groups receiving HB kidneys with (n=32) and without (n=32) ALG were also compared. RESULTS:ALT was elevated in 32 of 38 (84%) of NHB recipients and 19 of 64 (30%) controls (P<0.001). Mean peak ALT was 172+/-20 U/L in NHB and 42+/-6 U/L in HB kidneys (P<0.001). Use of ALG did not influence mean peak ALT. Elevated ALT predicted impaired graft function (P<0.02) and was associated with an increased length of delayed primary function (P<0.001) and risk of transplant nephrectomy (P<0.05). Thrombocytopenia (<100 x 10(9) cells/L) occurred in 18 of 38 (47%) NHB recipients and in 20 of 64 (31%) controls (P<0.05). Mean nadir platelet count (x 10(9) cells/L) was 113+/-10 in NHB, 128+/-9 in HB with ALG, and 164+/-9 in HB without ALG (both P<0.05 vs. NHB). Patients who underwent graft nephrectomy (n=9) had a disproportionate fall in platelet count (mean nadir, 80+/-11 x 10(9) cells/L; P<0.05). CONCLUSIONS:Transaminitis and thrombocytopenia occur commonly after NHB kidney transplantation and are predictive of graft outcome. Recognition of these changes may assist the early management of NHB renal recipients, and also reduce investigation of "anomalous" results in this setting.
journal_name
Transplantationjournal_title
Transplantationauthors
Andrews PA,Denton MD,Compton FC,Koffman CGdoi
10.1097/00007890-199705270-00005subject
Has Abstractpub_date
1997-05-27 00:00:00pages
1400-4issue
10eissn
0041-1337issn
1534-6080journal_volume
63pub_type
杂志文章相关文献
TRANSPLANTATION文献大全abstract:BACKGROUND:Apoptosis is a well-documented pathway for islet cell death. One potential mechanism is overexpression of death-promoting Bax compared with antiapoptotic Bcl-2 in islets. METHODS:We isolated islets from 10 human pancreata and measured the expression of Bax mRNA and Bcl-2 mRNA by real-time quantitative polym...
journal_title:Transplantation
pub_type: 杂志文章
doi:10.1097/00007890-200212150-00003
更新日期:2002-12-15 00:00:00
abstract::Immunosuppression with sirolimus and low-dose tacrolimus has facilitated successful clinical islet transplantation (CIT). Because the long-term effects on the kidney are unknown and immunosuppressant drugs can be nephrotoxic, CIT is currently restricted to patients with preserved renal function or a functioning renal ...
journal_title:Transplantation
pub_type: 杂志文章
doi:10.1097/01.tp.0000134971.15093.07
更新日期:2004-09-27 00:00:00
abstract:BACKGROUND:Aspartylglucosaminuria is a rare, inherited lysosomal disease characterized by a slowly progressive mental retardation and coarse facial and body features. With the intent to provide the deficient enzyme aspartylglucosaminidase, allogeneic stem-cell transplantation (ASCT) has been attempted. Only a few cases...
journal_title:Transplantation
pub_type: 杂志文章
doi:10.1097/00007890-200408150-00015
更新日期:2004-08-15 00:00:00
abstract::To determine whether a disparity at a single miH genetic loci are sufficient to generate GVHD in mice, we focused on well-known genetic alleleic differences at the miH gene loci, H3 and H4. For H3 congenic GVHD studies, C57BL/10 (H2b) mice were used as recipients of miH-disparate B10.LP-H3b donor cells. For H4 congeni...
journal_title:Transplantation
pub_type: 杂志文章
doi:10.1097/00007890-199602270-00017
更新日期:1996-02-27 00:00:00
abstract:BACKGROUND:Cytomegalovirus (CMV) replication has been associated with more risk for solid organ graft rejection. We wondered whether this association still holds when patients at risk receive prophylactic treatment for CMV. METHODS:We correlated CMV infection, biopsy-proven graft rejection, and graft loss in 1,414 pat...
journal_title:Transplantation
pub_type: 杂志文章,多中心研究
doi:10.1097/TP.0000000000000160
更新日期:2014-11-15 00:00:00
abstract:BACKGROUND:Interleukin- (IL) 10 may be a potent regulator for controlling of allograft rejection. A single administration of IL-10 is not effective for controlling graft rejection. Gene transfer is an attractive vehicle for prolonging the expression of short-lived proteins. METHODS:Donor or recipient livers were trans...
journal_title:Transplantation
pub_type: 杂志文章
doi:10.1097/00007890-200007270-00018
更新日期:2000-07-27 00:00:00
abstract:BACKGROUND:The shortage of livers for transplantation has prompted transplant centers to seek alternatives to conventional cadaveric liver transplantation. Left lateral segmentectomy from living donors has proven to be a safe operation for the donor with excellent results in the pediatric population. Left lobectomy, co...
journal_title:Transplantation
pub_type: 杂志文章
doi:10.1097/00007890-199909270-00012
更新日期:1999-09-27 00:00:00
abstract:BACKGROUND:The role of CD20+ B cells in renal allograft rejection has been reappreciated. Importantly, recent studies suggest a relation between CD20+ B cell aggregates and poorer clinical outcome. In the present study, we attempted to confirm these early reports in a tightly controlled patient population and to differ...
journal_title:Transplantation
pub_type: 杂志文章
doi:10.1097/TP.0b013e3181860a74
更新日期:2008-09-27 00:00:00
abstract::The use of anti-CD3 monoclonal antibodies to treat organ allograft rejection has been complicated by (1) the morbidity associated with the initial dose, (2) the humoral response of the patients against the mAbs, and (3) the generalized immunosuppression induced by the mAbs. We investigated the potential of F(ab')2 fra...
journal_title:Transplantation
pub_type: 杂志文章
doi:10.1097/00007890-199006000-00018
更新日期:1990-06-01 00:00:00
abstract:BACKGROUND:Calcineurin inhibitor-induced renal dysfunction is a major problem in liver transplantation. Interleukin-2 receptor antagonist induction followed by delayed tacrolimus (Tac) administration may minimize the renal insult without compromising immunoprotection. METHODS:This open, randomized, multicenter trial e...
journal_title:Transplantation
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1097/TP.0b013e3181db8cf0
更新日期:2010-06-27 00:00:00
abstract::We have previously demonstrated that subclinical chronic rejection (CR) induces structural and functional alterations in enteric smooth muscle and nerves in a rat model of small intestinal transplantation. This study was designed to investigate the effect of prolonged FK506 rescue therapy on these sequelae of CR. Immu...
journal_title:Transplantation
pub_type: 杂志文章
doi:
更新日期:1995-01-27 00:00:00
abstract:BACKGROUND:Islet transplantation studies with diabetic rodents frequently use treatment with diabetogens such as alloxan or streptozotocin to render hosts hyperglycemic. These chemicals produce unwanted toxic side effects, which complicate interpretations of damage produced by hyperglycemia versus direct toxin-induced ...
journal_title:Transplantation
pub_type: 杂志文章
doi:10.1097/00007890-200204270-00024
更新日期:2002-04-27 00:00:00
abstract::Transplant coronary artery disease and malignancy are the major limitations to survival after heart transplantation. In a randomized trial, mycophenolate mofetil (MMF) significantly improved 3-year survival over azathioprine, but the expected reduction in intracoronary ultrasound evidence of vasculopathy was not found...
journal_title:Transplantation
pub_type: 杂志文章,评审
doi:10.1097/01.tp.0000153302.27299.16
更新日期:2005-02-15 00:00:00
abstract::Cyclosporine CsA nephrotoxicity was examined in male Sprague-Dawley rats with or without prior uninephrectomy, injected daily with 12.5 mg/kg CsA, and fed a salt-depleted or normal diet for 3-10 weeks. Control rats received the CsA vehicle. CsA induced a fall in creatinine clearance in salt-depleted rats, from 1.3 +/-...
journal_title:Transplantation
pub_type: 杂志文章
doi:10.1097/00007890-199002000-00041
更新日期:1990-02-01 00:00:00
abstract::Donor pancreas utilization rates for whole organ transplant have remained low and have decreased over time. To identify the reasons for nonuse of pancreas from donors who meet common baseline acceptance criteria, we examined Organ Procurement and Transplantation Network data from 2005 to 2007 and identified a subgroup...
journal_title:Transplantation
pub_type: 社论,评审
doi:10.1097/TP.0b013e3181e9fea4
更新日期:2010-09-15 00:00:00
abstract:BACKGROUND:End-stage renal disease (ESRD) patients with antiphospholipid antibody syndrome (APAS) remain at high risk for the development of renal thrombosis without the benefit of anticoagulation therapy. This study examines the efficacy of anticoagulation therapy in this high-risk patient population. METHOD:Of nine ...
journal_title:Transplantation
pub_type: 杂志文章
doi:10.1097/01.tp.0000119157.81765.46
更新日期:2004-04-15 00:00:00
abstract::Nonmajor histocompatibility complex (non-MHC) antigens are important targets of graft rejection and graft-versus-host disease in clinical transplantation. Little is known regarding immunity to non-MHC antigens. To study this problem we evaluated the effect of antihuman thymocyte globulin (ATG) on reactivity in autolog...
journal_title:Transplantation
pub_type: 杂志文章
doi:10.1097/00007890-198102000-00001
更新日期:1981-02-01 00:00:00
abstract::A total of 159 patients received renal cadaveric grafts under 2 different allocation systems. System 1, a local variance (i.e., a point system different from that of United Network for Organ Sharing [UNOS]), and system 2, the current UNOS point system, differed in the relative emphasis on waiting time and HLA match. T...
journal_title:Transplantation
pub_type: 杂志文章
doi:
更新日期:1994-04-15 00:00:00
abstract::Cytomegalovirus remains a significant source of morbidity and mortality in immunocompromised hosts. The increased sensitivity of molecular diagnostic techniques (PCR, antigenemia) has resulted in our ability to detect viral replication earlier in the posttransplant period, before the onset of symptoms. With the advent...
journal_title:Transplantation
pub_type: 杂志文章
doi:10.1097/00007890-199701270-00017
更新日期:1997-01-27 00:00:00
abstract:BACKGROUND:Although longer pretransplant dialysis has been associated with poor kidney transplant outcome, no data about this association exist from the current era or from Europe. We studied the association of pretransplant dialysis duration on outcomes after kidney transplantation across two different time periods. ...
journal_title:Transplantation
pub_type: 杂志文章
doi:10.1097/TP.0000000000000085
更新日期:2014-08-27 00:00:00
abstract:BACKGROUND:Endomyocardial biopsy (EMB) remains the gold standard for acute cellular rejection (ACR) diagnosis in cardiac transplantation yet is subject to interobserver variability. A method that could avoid discordant EMB analysis would be desirable. The apoptosis rate in EMB correlates with ACR severity. Apollon inhi...
journal_title:Transplantation
pub_type: 杂志文章
doi:10.1097/TP.0b013e3181c3c690
更新日期:2010-01-27 00:00:00
abstract::The major role of anti-alphaGal antibodies in the hyperacute rejection of pig organs by humans and baboons has been clearly demonstrated. Spacered alpha-galactose disaccharide (Gal(alpha1)-3Gal) hapten was produced by chemical synthesis and covalently attached to a flexible, hydrophilic polymer (PAA), which in turn wa...
journal_title:Transplantation
pub_type: 杂志文章
doi:10.1097/00007890-199611270-00001
更新日期:1996-11-27 00:00:00
abstract::In 2007, the islet community was notified that the collagenase product most commonly used for human islet isolations contained bovine neural tissue contaminants. To minimize this potential hazard, we adapted our human islet processing procedure to use a GMP-manufactured, bovine neural tissue-free collagenase blend. He...
journal_title:Transplantation
pub_type: 杂志文章,评审
doi:10.1097/TP.0b013e3181b443ae
更新日期:2009-09-27 00:00:00
abstract:BACKGROUND:Allografts are occasionally accepted in the absence of immunosuppression. Because naturally occurring CD4(+)CD25(+) regulatory T cells (natural CD25(+) Treg cells) have been shown to inhibit allograft rejection, we investigated their influence on the outcome of allografts in nonimmunosuppressed mouse recipie...
journal_title:Transplantation
pub_type: 杂志文章
doi:10.1097/01.tp.0000155179.61445.78
更新日期:2005-03-27 00:00:00
abstract:BACKGROUND:This study aimed at investigating the efficacy of the novel immunosuppressant FK778 to prevent the development and progression of chronic allograft vasculopathy (CAV). METHODS:Orthotopic aortic transplantations were performed in the PVG-to-ACI rat model and followed over the course of 120 days. Immunosuppre...
journal_title:Transplantation
pub_type: 杂志文章
doi:10.1097/TP.0b013e3181673608
更新日期:2008-03-27 00:00:00
abstract::We describe a patient transfused with 200 ml of donor fresh whole blood three times at 2-week intervals. Three weeks after the last transfusion, transplantation and splenectomy were done at the same time. Splenic cells from this DST pretreated patient were fused with murine myeloma cells (X63-Ag8, 653). With DST pretr...
journal_title:Transplantation
pub_type: 杂志文章
doi:10.1097/00007890-198909000-00022
更新日期:1989-09-01 00:00:00
abstract:BACKGROUND:Sexual function is altered in patients with type 1 diabetes (T1D) and end-stage renal disease (ESRD), thus affecting quality of life. The present study aimed to analyze sexual function in patients with T1D and ESRD (T1D+ESRD) who received a simultaneous kidney-pancreas (KP) or kidney-alone (KD) transplantati...
journal_title:Transplantation
pub_type: 杂志文章
doi:10.1097/TP.0b013e31822c6eb8
更新日期:2011-10-15 00:00:00
abstract::The effect of FK506 and cyclosporine on NK and ADCC activity was evaluated. Cytotoxic cells mediating both activities are resistant to FK506. In contrast, preincubation of ADCC and NK effectors with cyclosporine decreases their cytotoxic potential, while adding the drug to the assays is without effect. ...
journal_title:Transplantation
pub_type: 杂志文章
doi:10.1097/00007890-199101000-00045
更新日期:1991-01-01 00:00:00
abstract:BACKGROUND:Circulating transthyretin (TTR) is derived from the liver, and orthotopic liver transplantation (OLT) is widely performed for variant TTR-associated familial amyloid polyneuropathy (FAP). The effect of OLT on FAP-related cardiac amyloid is of particular interest because wild-type TTR can itself be deposited ...
journal_title:Transplantation
pub_type: 杂志文章
doi:10.1097/00007890-199807270-00016
更新日期:1998-07-27 00:00:00
abstract::BK polyoma virus causes allograft dysfunction as a result of tubulo-interstitial nephritis in 2% to 5% of renal transplant recipients. The incidence of BK virus infection among renal transplant recipients in India is unknown. We used routine histologic examination, immunohistochemistry, and electron microscopy to retr...
journal_title:Transplantation
pub_type: 杂志文章
doi:10.1097/01.TP.0000113163.02039.30
更新日期:2004-02-15 00:00:00