Abstract:
BACKGROUND:Status 1A patients are prioritized over liver disease patients regardless of Model for End-stage Liver Disease (MELD) score. We aimed to identify groups with high waitlist mortality in Status 1A and MELD ≥40 patients to determine who would most benefit from transplantation. METHODS:Data on patients listed as Status 1A (n = 4447) and MELD ≥40 (n = 3663) over 15 years (2002-2017) was obtained from United Network for Organ Sharing/Organ Procurement and Transplant Network registry. They were divided into 2-derivation and validation groups. Risk factors associated with 28-day waitlist mortality were identified in derivation group and provided risk scores to divide patients into risk groups. Score system was applied to validation group to check its applicability. RESULTS:Risk factors for waitlist mortality in Status 1A included life support, performance status, severe coagulopathy, severe hypo or hypernatremia, and grade 3-4 encephalopathy. Risk factors in MELD ≥40 included higher MELD scores (≥45), age, sex, race, life support, and encephalopathy. On comparing 7- and 28-day mortality, both were higher in Status 1A and MELD ≥40 high-risk groups compared with low-risk groups in the derivation group (P < 0.001). Probability of transplantation was lowest for high-risk MELD ≥40 patients compared with all other groups (P < 0.001). These findings were reproduced in the validation set. Our proposed risk stratification system also showed acceptable 1-year graft and patient survival in high-risk groups. CONCLUSIONS:Our risk scoring system for extremely ill liver transplant candidates successfully stratified risk of waitlist mortality. Waitlist outcomes might be improved by modifications involving categorization of patients based on the presence/absence of risk factors.
journal_name
Transplantationjournal_title
Transplantationauthors
Safwan M,Nwagu U,Collins K,Abouljoud M,Nagai Sdoi
10.1097/TP.0000000000002651subject
Has Abstractpub_date
2019-10-01 00:00:00pages
2121-2129issue
10eissn
0041-1337issn
1534-6080journal_volume
103pub_type
杂志文章相关文献
TRANSPLANTATION文献大全abstract::It has been reported that cultured keratinocyte (CK) allografts are not rejected in mice, unlike in other species. Several reports have suggested that mouse CK allografts are incapable of stimulating a primary alloresponse, including sensitization of recipients to alloantigens. In this study, we investigated the immun...
journal_title:Transplantation
pub_type: 杂志文章
doi:
更新日期:1994-07-15 00:00:00
abstract:BACKGROUND:The infiltration of epithelium by CD8+ T lymphocytes in human renal or liver allografts is a critical feature of acute rejection. CD103 expression can be acquired in vitro by CD8+ cytotoxic T lymphocytes in response to allogeneic renal epithelial cells and promotes their adhesion to epithelium and subsequent...
journal_title:Transplantation
pub_type: 杂志文章
doi:
更新日期:2000-07-15 00:00:00
abstract:BACKGROUND:Second-set rejection is generally regarded as a phenomenon mainly mediated by humoral cytotoxic antibodies, although a few discordant data have been presented. In the reported experiments, we have taken advantage of the absence of production of specific cytotoxic alloantibodies contrasting with the normal de...
journal_title:Transplantation
pub_type: 杂志文章
doi:10.1097/00007890-200004150-00041
更新日期:2000-04-15 00:00:00
abstract::Vascular endothelial cells (VEC) are clearly immunogenic and express antigens unique to vascular endothelial cells. The observation that peripheral blood monocytes also express this VEC antigen system made prospective testing feasible. Preformed antibody to the VEC/monocyte antigen system of the donor usually leads to...
journal_title:Transplantation
pub_type: 杂志文章
doi:10.1097/00007890-198503000-00016
更新日期:1985-03-01 00:00:00
abstract::Sixty-two adults who underwent orthotopic liver transplantations between February 1981 and June 1983 were followed for a mean of 170 days after the operation. Twenty-six patients developed 30 episodes of significant fungal infection. Candida species and Torulopsis glabrata were responsible for 22 episodes and Aspergil...
journal_title:Transplantation
pub_type: 杂志文章
doi:10.1097/00007890-198510000-00002
更新日期:1985-10-01 00:00:00
abstract:BACKGROUND:Ischemia-reperfusion syndrome has been recognized as an important pathogenic factor in renal transplantation, not only in the development of delayed graft function but also in the development of acute and chronic rejection. Hypoxia-inducible factor (HIF)-1 activates transcription of several genes implicated ...
journal_title:Transplantation
pub_type: 杂志文章
doi:10.1097/01.TP.0000063128.86981.B2
更新日期:2003-05-27 00:00:00
abstract::To examine whether cyclosporine (CsA) has mutagenic potential against human cells, we analyzed sister chromatid exchange (SCE) induction by CsA using human lymphocytes in vitro. SCE frequencies increased significantly in the lymphocytes treated with 1 microgram/ml and 5 micrograms/ml CsA, though the frequencies seemed...
journal_title:Transplantation
pub_type: 杂志文章
doi:
更新日期:1986-07-01 00:00:00
abstract:BACKGROUND:Airway complications continue to be an important source of morbidity and mortality after lung transplantation (LTx). Different approaches have been used for their nonsurgical management. We describe our experience using self-expandable metallic stents (SEMSs) in patients with airway complications post-LTx. ...
journal_title:Transplantation
pub_type: 杂志文章
doi:10.1097/01.TP.0000061229.83500.A0
更新日期:2003-05-15 00:00:00
abstract:BACKGROUND:The authors studied the relationship between the dynamics of Epstein-Barr virus (EBV) load, CD8 T-cell activation and differentiation, and EBV-associated symptoms in 25 children after kidney transplantation (Tx). METHODS:Twenty-two patients were enrolled at the time of Tx and three at diagnosis of EBV-induc...
journal_title:Transplantation
pub_type: 杂志文章
doi:10.1097/01.tp.0000131168.21930.5c
更新日期:2004-06-15 00:00:00
abstract:BACKGROUND:Successful pancreatic islet transplantation (PIT) has resulted in several transplant centers wanting to start PIT programs. PIT remains experimental and must be performed safely for its continued use. We describe the radiographic techniques used at our center and their results. METHODS:Between January 17, 2...
journal_title:Transplantation
pub_type: 杂志文章
doi:10.1097/01.TP.0000073976.26604.96
更新日期:2003-07-15 00:00:00
abstract::A total of 151 potential recipients of kidney grafts from one-HLA-haplotype-mismatched MLC-positive (RR greater than 20%) donors treated during 1980-1984 was investigated. The recipients were divided retrospectively into four groups: (A) 42 patients who received pretransplant donor-specific transfusions (DST) and post...
journal_title:Transplantation
pub_type: 杂志文章
doi:
更新日期:1986-07-01 00:00:00
abstract:BACKGROUND:Donor-derived cell-free DNA (dd-cfDNA) is a potential noninvasive molecular marker of graft rejection after kidney transplant, whose diagnostic accuracy remains controversial. METHODS:We performed a systematic review and meta-analysis to evaluate the diagnostic accuracy of dd-cfDNA. Relevant literature was ...
journal_title:Transplantation
pub_type: 杂志文章
doi:10.1097/TP.0000000000003443
更新日期:2020-09-02 00:00:00
abstract:BACKGROUND:In the acute rejection of allografts, the interaction between Fas (CD95) and its ligand (FasL; CD95L) has been shown to be involved in mediating apoptotic cell death. The role, however, of these molecules in the pathogenesis of transplant vascular sclerosis is as yet undetermined. The present study was there...
journal_title:Transplantation
pub_type: 杂志文章
doi:10.1097/00007890-199905270-00001
更新日期:1999-05-27 00:00:00
abstract:BACKGROUND:Preconditioning protects against both liver and lung damage after hepatic ischemia-reperfusion (I/R). Xanthine and xanthine oxidase (XOD) may contribute to the development of hepatic I/R. OBJECTIVE:To evaluate whether preconditioning could modulate the injurious effects of xanthine/XOD on the liver and lung...
journal_title:Transplantation
pub_type: 杂志文章
doi:10.1097/00007890-200204270-00004
更新日期:2002-04-27 00:00:00
abstract:BACKGROUND:Skin-autofluorescence (skin-AF) noninvasively measures the tissue accumulation of advanced glycation end products (AGEs). AGEs are nephrotoxic and potential effectors of cardiovascular mortality. We investigated whether skin-AF predicted graft loss after kidney transplantation. METHODS:A total of 302 renal ...
journal_title:Transplantation
pub_type: 杂志文章
doi:10.1097/TP.0b013e31819d3173
更新日期:2009-04-15 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::Until recently, islet allotransplantation for type 1 diabetic patients has been largely unsuccessful. Previous pharmacologic studies of single drugs have suggested that one factor contributing to this poor success is toxicity of immunosuppressive drugs on transplanted islets. However, no comprehensive study of agents ...
journal_title:Transplantation
pub_type: 杂志文章
doi:10.1097/00007890-200202150-00007
更新日期:2002-02-15 00:00:00
abstract:BACKGROUND:Bone marrow (BM) is an excellent source of mesenchymal stem cells (MSC) which can be expanded in vitro for further use. However, large volumes of BM specimens are not routinely available. We hypothesized that the normally discarded BM collection kits might be a convenient source of large numbers of MSC. MET...
journal_title:Transplantation
pub_type: 杂志文章
doi:10.1097/01.tp.0000259752.13304.0b
更新日期:2007-04-27 00:00:00
abstract:OBJECTIVES:To retrospectively compare the accuracy of pretransplant panel of reactivity antibodies (PRA) and serum level of soluble CD30 (sCD30) in predicting early (<6 months) acute rejection (AR) in living-donor and deceased-donor kidney-transplant (KT) patients. METHODS:Pretransplant sera of 24 KT recipients were r...
journal_title:Transplantation
pub_type: 杂志文章
doi:
更新日期:2005-05-15 00:00:00
abstract::Chronic kidney disease is common in patients with multiple myeloma. Historically, individuals with end-stage renal disease and multiple myeloma did poorly with renal transplantation due to higher mortality rates from the malignancy itself or associated comorbidities. However, over the past 2 decades, there have been s...
journal_title:Transplantation
pub_type: 杂志文章,评审
doi:10.1097/TP.0000000000002449
更新日期:2018-12-01 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::Living-donor liver transplantation has provided a solution to the severe lack of cadaveric grafts for the replacement of livers afflicted with end-stage cirrhosis, fulminant disease, or inborn errors of metabolism. The pioneering experience in Japan in the early 1990s helped open wide the avenues of a new branch of sc...
journal_title:Transplantation
pub_type: 杂志文章,评审
doi:10.1097/01.TP.0000046533.93621.C7
更新日期:2003-02-15 00:00:00
abstract:BACKGROUND:The relationship between institutional case volume and clinical outcomes after living donor liver transplantation is not clarified. METHODS:We conducted a nationwide retrospective cohort study using the database of Korean National Healthcare Insurance Service. Between January 2007 and December 2016, 7073 ad...
journal_title:Transplantation
pub_type: 杂志文章
doi:10.1097/TP.0000000000002394
更新日期:2019-05-01 00:00:00
abstract:BACKGROUND:The aim of this study was to assess the influence of IL-10 and TGFbeta1 gene polymorphisms on the development of acute rejection and coronary disease in pediatric heart transplant recipients. METHODS:Patients were classified as either Rejectors or Nonrejectors. Coronary artery disease (CAD) was diagnosed by...
journal_title:Transplantation
pub_type: 杂志文章
doi:10.1097/01.tp.0000202725.55923.37
更新日期:2006-03-27 00:00:00
abstract::Increased QT dispersion (QTd), predicting patients with risk of malignant arrhythmia, have recently been reported in hemodialysis patients (HDp). In this prospective study, we aimed to investigate changes in QTd and signal averaged-ECG (SAECG) in HDp after transplantation. Twenty-seven HDp (M/F:18/9, mean age 30+/-8 y...
journal_title:Transplantation
pub_type: 临床试验,杂志文章
doi:10.1097/00007890-200111150-00009
更新日期:2001-11-15 00:00:00
abstract::Spleen cells obtained from C57BL/Ks (Ks, H-2d) mice carrying passively enhanced Sarcoma I (Sa I, H-2a) tumors were tested for alloantibody formation, lymphocyte blastogenesis, antibody-dependent cellular cytotoxicity, and cell to cell cytotoxicity. Assays were usually performed approximately 6 weeks after tumor inocul...
journal_title:Transplantation
pub_type: 杂志文章
doi:10.1097/00007890-197803000-00011
更新日期:1978-03-01 00:00:00
abstract::A major impediment to the wider application of clinical liver transplantation is the paucity of acceptable organs. Most centers refuse organs that come from donors who are hepatitis B core antibody positive because of a fear of transmission of hepatitis B virus (HBV) infection to the recipient. The risk related to the...
journal_title:Transplantation
pub_type: 杂志文章
doi:10.1097/00007890-199908270-00013
更新日期:1999-08-27 00:00:00
abstract:BACKGROUND:In 2006, Northwestern Medicine implemented a culturally targeted and linguistically congruent Hispanic Kidney Transplant Program (HKTP). The HKTP has been associated with a reduction in Hispanic/Latino disparities in live donor kidney transplantation. This paper assessed the financial feasibility of implemen...
journal_title:Transplantation
pub_type: 杂志文章
doi:10.1097/TP.0000000000003269
更新日期:2020-04-09 00:00:00
abstract:BACKGROUND:Treatment of chronic hepatitis C virus (HCV) infection after renal allograft transplantation has been an obstacle because of contraindications associated with IFN-based therapies. Direct-acting antiviral agents are highly efficient treatment options that do not require IFN and may not require ribavirin. Ther...
journal_title:Transplantation
pub_type: 杂志文章
doi:10.1097/TP.0000000000001414
更新日期:2017-05-01 00:00:00
abstract:BACKGROUND:Donor hepatectomy with maximal safety while preserving graft viability is of principal concern in living donor liver transplantation. There are compelling reasons for avoiding blood transfusion, even with autologous blood, to avoid the potential risks it imposes on healthy donors. This study aims to describe...
journal_title:Transplantation
pub_type: 杂志文章
doi:10.1097/00007890-200006270-00018
更新日期:2000-06-27 00:00:00