Renal dysfunction in acute rejection. Effect of HLA typing, therapy, and histology.


:Acute rejection is a frequent cause of early graft dysfunction in renal transplantation, and serum creatinine is the most important measure of clinical response. However, there is little information on serum creatinine during rejection episodes. In this study, the determinants that might influence the clinical response of serum creatinine during acute rejection were evaluated in 96 renal transplant recipients with 100 episodes of biopsy-proven rejection, by univariate and multivariate analysis. The factors assessed for their influence on serum creatinine in acute rejection included: presence and severity of vascular or cellular rejection on biopsy, time taken to institute therapy, HLA mismatch, and the use of OKT3. The presence of vascular rejection on biopsy (n = 28) was a major determinant of impaired reciprocal area under the curve (AUC) of serum creatinine (P < 0.01), and was correlated with HLA-A and -B mismatch (r = 0.21, P < 0.05). Acute rejection associated with HLA-DR mismatch resulted in a more rapid increase of serum creatinine, a higher maximal creatinine, and a greater AUC creatinine (all P < 0.05). Treatment of acute rejection with OKT3 had a beneficial effect on AUC creatinine (P < 0.05) when compared with intravenous corticosteroids, by multivariate analysis. However, vascular rejection and HLA-DR mismatch had no effect on serum creatinine 1 year after transplantation. The biopsy cellular rejection score had no effect on AUC creatinine, although there was a modest effect on gradient of creatinine prior to biopsy. A minor adverse effect of delay in therapy of acute rejection could be demonstrated in the methylprednisolone-treated subgroup. In summary, HLA-DR mismatch and the presence of vascular rejection were the most important predictors of the severity of rejection assessed by the response of serum creatinine to treatment. Appropriate antirejection therapy should be instituted promptly to optimize clinical response during acute rejection.






Nankivell BJ,Allen RD,O'Connell PJ,Chapman JR




Has Abstract


1995-07-15 00:00:00












  • In vitro cytokine profiles and their relevance to rejection following renal transplantation.

    abstract::Graft rejection remains an important cause of renal allograft failure, despite improvements in immunosuppression and HLA typing. Although HLA matching is beneficial, ensuring an exact match it is often impractical. Thus, a reliable in vitro method for quantitating and qualitating alloreactivity is an important goal. I...


    pub_type: 杂志文章


    authors: Kaminski ER,Kaminski A,Bending MR,Chang R,Heads A,Szydlo RM,Pereira RS

    更新日期:1995-10-15 00:00:00

  • Zero-Time Renal Transplant Biopsies: A Comprehensive Review.

    abstract::Zero-time kidney biopsies, obtained at time of transplantation, are performed in many transplant centers worldwide. Decisions on kidney discard, kidney allocation, and choice of peritransplant and posttransplant treatment are sometimes based on the histological information obtained from these biopsies. This comprehens...


    pub_type: 杂志文章,评审


    authors: Naesens M

    更新日期:2016-07-01 00:00:00

  • The effect of cyclosporine and liver autotransplantation on bile flow and composition in dogs.

    abstract::Following liver transplantation bile formation may be influenced by hepatic denervation and cyclosporine therapy. To better establish any effect of liver transplantation on bile secretion, 6 mongrel dogs were studied: 3 underwent liver denervation by a modified autotransplantation procedure and insertion of a Thomas c...


    pub_type: 杂志文章


    authors: Sutherland FR,Preshaw RM,Shaffer EA

    更新日期:1993-02-01 00:00:00

  • Cold ischemia is a major determinant of acute rejection and renal graft survival in the modern era of immunosuppression.

    abstract:BACKGROUND:The aim of our study was to examine, in a recent cohort of kidney transplant recipients who have received modern immunosuppressive therapy, the respective role of cold ischemia time (CIT) and delayed graft function (DGF) on acute rejection (AR) rates and long-term graft survival. METHODS:We retrospectively ...


    pub_type: 杂志文章


    authors: Mikhalski D,Wissing KM,Ghisdal L,Broeders N,Touly M,Hoang AD,Loi P,Mboti F,Donckier V,Vereerstraeten P,Abramowicz D

    更新日期:2008-04-15 00:00:00

  • Combined liver-kidney transplantation is preferable to liver transplant alone for cirrhotic patients with renal failure.

    abstract:BACKGROUND:The role of combined liver-kidney transplantation (CLKT) for cirrhotic patients with renal failure (RF) is controversial. Since the model for end-stage liver disease era, there has been a rise in the number of CLKT. Using the Organ Procurement Transplant Network/United Network for Organ Sharing database, thi...


    pub_type: 杂志文章


    authors: Fong TL,Khemichian S,Shah T,Hutchinson IV,Cho YW

    更新日期:2012-08-27 00:00:00

  • Analysis of histoincompatibility in a natural population of the bisexual whiptail lizard Cnemidophorus tigris.

    abstract::Histoincompatibility was analyzed to describe as precisely as possible the sequence of gross morphological events taking place during allograft rejection among closely related conspecifics from a natural population of the bisexual lizard Cnemidophorus tigris. Two types of rejection were noted, depending on whether the...


    pub_type: 杂志文章


    authors: Cuellar O,Smart C

    更新日期:1977-08-01 00:00:00

  • Liver transplantation in the first three months of life.

    abstract:BACKGROUND:Pediatric liver transplant recipients have traditionally been grouped according to age. Age-based classification schemes are useful in identifying clinical problems in selected age groups and also for developing solutions to these problems. Although infants in the first 3 months of life have not traditionall...


    pub_type: 杂志文章


    authors: Woodle ES,Millis JM,So SK,McDiarmid SV,Busuttil RW,Esquivel CO,Whitington PF,Thistlethwaite JR

    更新日期:1998-09-15 00:00:00

  • Separate clones of cytotoxic T lymphocytes are generated against private and public H-2 antigens.

    abstract::By cytolysis and monolayer absorption tests, the kinetics of the generation of CBA/H cytotoxic lymphocytes (Tc) in response to stimulation by H-2b antigens have been analyzed in vitro. The Tc population which reacts with public antigens of H-2b and H-2d strains shows peak activity in culture at 4 to 5 days, then rapi...


    pub_type: 杂志文章


    authors: Schnagl HY,Boyle W

    更新日期:1980-06-01 00:00:00

  • Mannitol infusion within 15 min of cross-clamp improves living donor kidney preservation.

    abstract:BACKGROUND:Optical coherence tomography (OCT) revealed that cells lining proximal convoluted tubules of living donor kidneys (LDKs) procured by laparoscopic procedures were very swollen in response to the brief period of ischemia experienced between the time of arterial vessel clamping and flushing the excised kidney w...


    pub_type: 杂志文章


    authors: Andrews PM,Cooper M,Verbesey J,Ghasemian S,Rogalsky D,Moody P,Chen A,Alexandrov P,Wang HW,Chen Y

    更新日期:2014-10-27 00:00:00

  • Control of organ transplant-associated graft-versus-host disease by activated host lymphocyte infusions.

    abstract:BACKGROUND:Prolonged persistence of donor-derived T cells after organ transplantation has been proposed to improve long-term allograft survival. However, surviving transplant-derived T cells are also able to mediate devastating graft-versus-host disease (GvHD). Currently, GvHD after organ transplantation is usually ref...


    pub_type: 杂志文章


    authors: Kuball J,Theobald M,Ferreira EA,Hess G,Burg J,Maccagno G,Barreiros AP,Lüth S,Schimanski CC,Schuchmann M,Schwarting A,Neurath M,Otto G,Galle PR,Lohse AW

    更新日期:2004-12-27 00:00:00

  • Improvement in 3-month patient-reported gastrointestinal symptoms after conversion from mycophenolate mofetil to enteric-coated mycophenolate sodium in renal transplant patients.

    abstract:BACKGROUND:The benefit of conversion from mycophenolate mofetil (MMF) to enteric-coated mycophenolate sodium (EC-MPS) in terms of gastrointestinal symptom burden has been evaluated previously using patient-reported outcomes. However, data are lacking concerning the sustained effect of conversion over time, and the pote...


    pub_type: 临床试验,杂志文章,多中心研究


    authors: Bolin P,Tanriover B,Zibari GB,Lynn ML,Pirsch JD,Chan L,Cooper M,Langone AJ,Tomlanovich SJ

    更新日期:2007-12-15 00:00:00

  • Coronary calcifications detected by computed tomography are not markers of cardiac allograft vasculopathy.

    abstract:BACKGROUND:Cardiac allograft vasculopathy (CAV) still limits survival after heart transplantation. Currently available noninvasive tests are of inferior value to detect CAV, and thus invasive coronary angiography (ICA) is frequently performed. Cardiac dual-source computed tomography calcium scoring (DSCTCS) offers the ...


    pub_type: 杂志文章


    authors: von Ziegler F,Kaczmarek I,Knez A,Greif M,Rümmler J,Meiser B,Reichart B,Becker C,Steinbeck G,Becker A

    更新日期:2011-08-27 00:00:00

  • Rimonabant affects cyclosporine a, but not tacrolimus pharmacokinetics in renal transplant recipients.

    abstract:BACKGROUND:Obesity is a common problem following renal transplantation. Rimonabant, a cannabinoid-1 receptor blocker, offers a new approach for reducing obesity. METHODS:The potential pharmacokinetic interaction between rimonabant and cyclosporine A (CsA, n=10) and tacrolimus (Tac, n=8) was assessed in stable renal tr...


    pub_type: 杂志文章


    authors: Amundsen R,Asberg A,Robertsen I,Vethe NT,Bergan S,Hartmann A,Midtvedt K

    更新日期:2009-04-27 00:00:00

  • Effects of protein-calorie restriction on the immune response to skin allografts in the rat.

    abstract::The effect of protein depletion on immune responsiveness was examined using a skin allograft model. Protein depletion was induced in adult Fischer (F344) male rats by the ad libitum provision of a 5% protein diet. Total serum protein, total body weight, total body nitrogen, and total body lipid were all markedly decre...


    pub_type: 杂志文章


    authors: Austin EH,Brennan MF,Rosenberg SA

    更新日期:1980-09-01 00:00:00

  • Factors with an impact on chimerism development and long-term survival after umbilical cord blood transplantation.

    abstract:BACKGROUND:Umbilical cord blood transplantation (UCBT) is increasingly used and produces similar results to matched unrelated donor transplantation. METHODS:We performed a retrospective single-center analysis of 50 umbilical cord blood transplantations UCBTs performed from 2001 to 2010, including 37 single and 13 doub...


    pub_type: 杂志文章


    authors: Berglund S,Le Blanc K,Remberger M,Gertow J,Uzunel M,Svenberg P,Winiarski J,Ljungman P,Ringdén O,Uhlin M,Mattsson J

    更新日期:2012-11-27 00:00:00

  • Characterisation of collagen VI within the islet-exocrine interface of the human pancreas: implications for clinical islet isolation?

    abstract:BACKGROUND:To optimize the methods used for human islet isolation for transplantation, it is important to improve our understanding of the structure of the islet-exocrine interface. In this study, the composition of collagen subtypes in the interface have been characterized and quantified in human pancreas. METHODS:Hu...


    pub_type: 杂志文章


    authors: Hughes SJ,Clark A,McShane P,Contractor HH,Gray DW,Johnson PR

    更新日期:2006-02-15 00:00:00

  • Adult living-donor liver transplantation with ABO-incompatible grafts.

    abstract:BACKGROUND:Liver transplantation using ABO-incompatible grafts is rarely performed because the reported outcome is poorer than with compatible grafts. We report our positive experience with adult-to-adult living-donor liver transplant (LDLT) using ABO-incompatible grafts. METHODS:The immunosuppressive protocol consist...


    pub_type: 杂志文章


    authors: Testa G,Vidanovic V,Chejfec G,Gangemi A,Iqpal R,Porubsky M,Pham T,Benedetti E

    更新日期:2008-03-15 00:00:00

  • Relationship between ABO blood group and levels of Gal alpha,3Galactose-reactive human immunoglobulin G.

    abstract:BACKGROUND:The terminal Gal alpha1,3Galactose (alphaGal) determinant is present on all porcine glycoproteins and glycolipids, but is not expressed by human cells. Consequently human sera contain anti-alphaGal natural antibodies. The human blood group B antigen [Gal alpha1,3(Fuc1,2)Galactose] is differentiated from the ...


    pub_type: 杂志文章


    authors: McMorrow IM,Comrack CA,Nazarey PP,Sachs DH,DerSimonian H

    更新日期:1997-08-15 00:00:00

  • Conversion to sirolimus and mycophenolate can attenuate the progression of bronchiolitis obliterans syndrome and improves renal function after lung transplantation.

    abstract:BACKGROUND:Bronchiolitis obliterans syndrome (BOS) is the major problem after lung and heart-lung transplantation (LTx/HLTx). Sirolimus (Sir) and Mycophenolate (MMF) showed a promising efficacy in the treatment of BOS in animal models. The first clinical experience in converting LTx/HLTx-recipients with BOS from calcin...


    pub_type: 临床试验,杂志文章


    authors: Groetzner J,Wittwer T,Kaczmarek I,Ueberfuhr P,Strauch J,Nagib R,Meiser B,Franke U,Reichart B,Wahlers T

    更新日期:2006-02-15 00:00:00

  • The effect of perioperative portal venous injection of donor spleen cells on renal allograft survival in dogs.

    abstract::Preoperative portal venous injection of donor lymphocytes has been shown to extend allograft survival in inbred animals. However, the effect of perioperative injection in a large animal model has not been carefully studied. We examined the effect of perioperative (day 0) donor spleen cell administration in a canine ki...


    pub_type: 杂志文章


    authors: Tsuji T,Tashiro S,Tanabe D,Sawada T,Inoue K,Kawamoto S,Kamimoto Y,Miyauchi Y

    更新日期:1994-10-27 00:00:00

  • Acute rejection and cardiac allograft vascular disease is reduced by suppression of subclinical cytomegalovirus infection.

    abstract:BACKGROUND:Anticytomegalovirus (CMV) prophylaxis prevents the acute disease but its impact on subclinical infection and allograft outcome is unknown. We sought to determine whether CMV prophylaxis administered for three months after heart transplant would improve patient outcomes. METHODS:This prospective cohort study...


    pub_type: 临床试验,杂志文章


    authors: Potena L,Holweg CT,Chin C,Luikart H,Weisshaar D,Narasimhan B,Fearon WF,Lewis DB,Cooke JP,Mocarski ES,Valantine HA

    更新日期:2006-08-15 00:00:00

  • Rapamycin Prolongs Graft Survival and Induces CD4+IFN-γ+IL-10+ Regulatory Type 1 Cells in Old Recipient Mice.

    abstract:BACKGROUND:Although the elderly represents a rapidly growing population among transplant recipients, age-specific aspects have not been considered sufficiently in clinical trials. Moreover, age-specific effects of immunosuppressive therapies remain poorly understood. METHODS:Here, we assessed the impact of rapamycin o...


    pub_type: 杂志文章


    authors: Quante M,Heinbokel T,Edtinger K,Minami K,Uehara H,Nian Y,Azuma H,Abdi R,Elkhal A,Tullius SG

    更新日期:2018-01-01 00:00:00

  • The decrease in organ donations from 1985 to 1990 caused by increasing medical contraindications and refusals by relatives.

    abstract::After the progressive improvement in the results of organ transplantation we now face the challenge of shortage in organ supply. The decreasing number of organ retrievals performed in 1990 at our hospital has raised questions concerning loss of potential organ donors and opposition to donation by the next of kin. We i...


    pub_type: 杂志文章


    authors: Faltin DL,Jeannet M,Suter PM

    更新日期:1992-07-01 00:00:00

  • Expression of MRP2 and MRP3 during liver regeneration after 90% partial hepatectomy in rats.

    abstract:BACKGROUND:Small-for-size grafts often cause persistent conjugated hyperbilirubinemia in the recipient after adult-to-adult living donor liver transplantation, but the cause has not yet been clarified. In physiologic status, bilirubin is excreted from hepatocytes to the bile canaliculus by means of multidrug resistance...


    pub_type: 杂志文章


    authors: Chang TH,Hakamada K,Toyoki Y,Tsuchida S,Sasaki M

    更新日期:2004-01-15 00:00:00

  • Real-time direct measurement of human liver allograft temperature from recovery to transplantation.

    abstract::Temperature is a key parameter in organ preservation that has been consistently linked to primary nonfunction (PNF). In this communication, and for the first time anywhere, continued and direct measurements of human liver intraparenchymal temperatures are reported in six clinical cases of orthotopic liver transplantat...


    pub_type: 杂志文章


    authors: Villa R,Fondevila C,Erill I,Guimerà A,Bombuy E,Gómez-Suárez C,Sacristán JC,García-Valdecasas JC

    更新日期:2006-02-15 00:00:00

  • Developing Statistical Models to Assess Transplant Outcomes Using National Registries: The Process in the United States.

    abstract::Created by the US National Organ Transplant Act in 1984, the Scientific Registry of Transplant Recipients (SRTR) is obligated to publicly report data on transplant program and organ procurement organization performance in the United States. These reports include risk-adjusted assessments of graft and patient survival,...


    pub_type: 杂志文章,评审


    authors: Snyder JJ,Salkowski N,Kim SJ,Zaun D,Xiong H,Israni AK,Kasiske BL

    更新日期:2016-02-01 00:00:00

  • Renal replacement therapy and orthotopic liver transplantation: the role of continuous veno-venous hemodialysis.

    abstract:BACKGROUND:The need for renal replacement therapy (RRT) either before or after orthotopic liver transplant (OLTX) has been reported to be a poor prognostic indicator for survival. Use of continuous veno-venous hemodialysis (CVVHD) for RRT has been reported in three series of OLTX patients with high 90-day mortality rat...


    pub_type: 杂志文章


    authors: Gonwa TA,Mai ML,Melton LB,Hays SR,Goldstein RM,Levy MF,Klintmalm GB

    更新日期:2001-05-27 00:00:00

  • Induction of class II major histocompatibility antigens on thyroid, adult pancreatic islet, and fetal proislet allografts.

    abstract::Cultured BALB/c (H-2d) thyroid, adult pancreatic islet and fetal proislet tissues can be accepted permanently in CBA/H (H-2k) recipients until rejection is triggered by the transfer of antidonor strain activated immune T cells. Class II MHC antigens are not expressed on the accepted grafts and are induced following im...


    pub_type: 杂志文章


    authors: Warren HS,Hodder MJ,Allan W,Hume DA,Simeonovic CJ

    更新日期:1992-04-01 00:00:00

  • Effect of poverty and other socioeconomic variables on renal allograft survival.

    abstract:BACKGROUND:Socioeconomic variables including low income and noncompliance impact negatively upon long-term renal allograft survival, especially in African Americans. We sought to determine whether other socioeconomic variables contributed to noncompliance and allograft survival. METHODS:A detailed history of socioecon...


    pub_type: 杂志文章


    authors: Butkus DE,Dottes AL,Meydrech EF,Barber WH

    更新日期:2001-07-27 00:00:00

  • Postirradiation recovery of lymphoid cells in the rat.

    abstract::Whole-body irradiation has been extensively used to ablate immune responsiveness in rodent recipients in adoptive allograft assays. This study was undertaken to determine the relative radioresistance and the tempo of regeneration, following whole-body irradiation, of cells involved in the allograft response. Six disti...


    pub_type: 杂志文章


    authors: Farnsworth A,Wotherspoon JS,Dorsch SE

    更新日期:1988-09-01 00:00:00