The Relationships Between Cold Ischemia Time, Kidney Transplant Length of Stay, and Transplant-related Costs.

Abstract:

BACKGROUND:Recent changes in policies guiding allocation of transplant kidneys are predicted to increase sharing between distant geographic regions. The potential exists for an increase in cold ischemia time (CIT) with resulting increases in delayed graft function (DGF) and transplant-related costs (TRC). We sought to explore the impact of CIT on metrics that may influence TRC. METHODS:Between 2006 and 2014, 81 945 adult solitary deceased donor kidney transplants were performed in the United States; 477 (0.6%) at our institution. Regression models were constructed to describe the relationship between CIT on DGF and length of stay (LOS). Using hospital accounting data, we created regression models to evaluate the effect of DGF on LOS and TRC. RESULTS:In multivariable models, longer CIT was associated with an increased rate of DGF (odds ratio [OR], 1.41; 95% confidence interval [CI], 1.38-1.44) and increased LOS (OR, 1.04; 95% CI, 1.02-1.05). Recipients at our institution who developed DGF had longer LOS (OR, 1.71; 95% CI, 1.50-1.95), suggesting that the effect is partially mediated by DGF. After adjusting for LOS, neither CIT nor DGF were independently associated with increased TRC. However, an increased LOS resulted in an increase in TRC by US $3422 (95% CI, US $3180 to US $3664) per additional day, indicating that the effect of CIT on TRC is partially mediated through LOS. CONCLUSIONS:The prolongation of CIT is associated with an increase in DGF rates and LOS, resulting in increased TRC. This study raises the need to balance increased access of traditionally underserved populations to kidney transplant with the inadvertent increase in TRC.

journal_name

Transplantation

journal_title

Transplantation

authors

Serrano OK,Vock DM,Chinnakotla S,Dunn TB,Kandaswamy R,Pruett TL,Feldman R,Matas AJ,Finger EB

doi

10.1097/TP.0000000000002309

subject

Has Abstract

pub_date

2019-02-01 00:00:00

pages

401-411

issue

2

eissn

0041-1337

issn

1534-6080

journal_volume

103

pub_type

杂志文章
  • 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,...

    journal_title:Transplantation

    pub_type: 杂志文章,评审

    doi:10.1097/TP.0000000000000891

    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

  • Prolongation of cardiac xenograft survival in rats receiving cyclosporin A.

    abstract::The effect of cyclosporin A was tested in a heterotopic cardiac xenograft model, in which hamster hearts were implanted into LEW rats. Despite the presence of low titers of rat anti-hamster lymphocytotoxic antibodies immediate rejection of the hamster hearts did not occur, suggesting that this model represented a xeno...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/00007890-198103000-00004

    authors: Homan WP,Williams KA,Fabre JW,Millard PR,Morris PJ

    更新日期:1981-03-01 00:00:00

  • The clinical utility of whole blood versus plasma cytomegalovirus viral load assays for monitoring therapeutic response.

    abstract:BACKGROUND:In patients with cytomegalovirus (CMV) disease, regular monitoring of viral loads and treatment until negative are recommended. However, with more sensitive polymerase chain reaction (PCR) assays and cellular peripheral sample types, detection of low-level viremia is achievable. We compared a whole blood rea...

    journal_title:Transplantation

    pub_type: 杂志文章,多中心研究,随机对照试验

    doi:10.1097/TP.0b013e3181ff8719

    authors: Lisboa LF,Asberg A,Kumar D,Pang X,Hartmann A,Preiksaitis JK,Pescovitz MD,Rollag H,Jardine AG,Humar A

    更新日期:2011-01-27 00:00:00

  • Effect of sirolimus on the metabolism of apoB100- containing lipoproteins in renal transplant patients.

    abstract:BACKGROUND:Sirolimus (Rapamune, rapamycin, RAPA) is a potent immunosuppressive drug that has reduced the rate of acute rejection episodes by more than 40% in phase III trials when added to an immunosuppression regimen of cyclosporine (CsA) and prednisone. However, RAPA treatment tends to increase lipid levels, particul...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/00007890-200110150-00011

    authors: Hoogeveen RC,Ballantyne CM,Pownall HJ,Opekun AR,Hachey DL,Jaffe JS,Oppermann S,Kahan BD,Morrisett JD

    更新日期:2001-10-15 00:00:00

  • Phenotypic analysis of oral tolerance to alloantigens: evidence that the indirect pathway of antigen presentation is involved.

    abstract:BACKGROUND:Oral administration of alloantigens induces down-regulation of Th1 immune responses and reduces the incidence of corneal graft rejection. This study examined the role of Th1 and Th2 cytokines, accessory cells, and lymphoid organs that are known to be instrumental in other forms of antigen-specific tolerance....

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/00007890-200205150-00021

    authors: Niederkorn JY,Mayhew E

    更新日期:2002-05-15 00:00:00

  • Reduction of degranulation of polymorphonuclear leukocytes by immunosuppression in patients following cadaveric renal transplantation.

    abstract::Plasma levels of main granulocyte components of patients after cadaveric renal transplantation were compared 9 days postoperative with the plasma levels of patients undergoing aortofemoral and iliacofemoral bypass operation or abdominal surgery. Lactoferrin values were significantly lower in patients under immunosuppr...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/00007890-198901000-00032

    authors: Hörl WH,Wanner C,Riegel W,Schlosser W,Wilms H,Schollmeyer P

    更新日期:1989-01-01 00:00:00

  • A prospective randomized multicenter study of tacrolimus in combination with sirolimus in renal-transplant recipients.

    abstract:BACKGROUND:Recently, sirolimus (SRL) was introduced as an immunosuppressant in solid-organ transplantation. This study evaluated combinations of SRL and tacrolimus (Tac). METHODS:This 6-month study investigated the safety and efficacy of Tac and steroids in combination with three different doses of SRL in renal-transp...

    journal_title:Transplantation

    pub_type: 临床试验,杂志文章,多中心研究,随机对照试验

    doi:10.1097/01.TP.0000071301.86299.75

    authors: van Hooff JP,Squifflet JP,Wlodarczyk Z,Vanrenterghem Y,Paczek L

    更新日期:2003-06-27 00:00:00

  • Effect of FK506 treatment on allocytolytic T lymphocyte induction in vivo: differential effects of FK506 on L3T4+ and Ly2+ T cells.

    abstract::Although FK506 has been widely investigated as a potent suppressor of organ allograft rejection in animals, little is known about the effect of FK506 on T cell responses to allografts in vivo. In the present study, we have studied the effect of FK506 on the induction of allocytolytic T lymphocyte using mice primed wit...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/00007890-199008000-00021

    authors: Maruyama M,Suzuki H,Yamashita N,Yano S

    更新日期:1990-08-01 00:00:00

  • CD4 Th2 cells do not functionally suppress CTL generation in neonatal tolerant mice.

    abstract::Injecting semiallogeneic CAF1 spleen into BALB/c newborn mice renders mice tolerant, and the majority of mice show prolonged survival of tolerogen-bearing A/J skin grafts. Moreover, graft survival is associated with enhanced Th2 cytokine responses and graft rejection with Th1 cytokine responses. To further delineate t...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:

    authors: Gao Q,Chen N,Field EH

    更新日期:1995-12-15 00:00:00

  • Glycans derived from porcine stomach mucin are effective inhibitors of natural anti-alpha-galactosyl antibodies in vitro and after intravenous infusion in baboons.

    abstract::The current shortage of donor organs has stimulated investigation of pig-to-human xenotransplantation as a practical alternative to allotransplantation. However, a major obstacle to this xenotransplantation is hyperacute rejection, which is believed to be initiated by the interaction of natural anti-alpha-galactosyl (...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/00007890-199611150-00026

    authors: Li SF,Neethling FA,Taniguchi S,Yeh JC,Kobayashi T,Ye Y,Koren E,Cummings RD,Cooper DK

    更新日期:1996-11-15 00:00:00

  • Nutritional immunomodulation enhances cardiac allograft survival in rats treated with donor-specific transfusion and cyclosporine.

    abstract::The aim of this study was to assess the efficacy of an enteral diet fortified with arginine, RNA, and fish oil (Impact), alone and in combination with cyclosporine (CsA) and donor-specific transfusion (DST) on allograft survival in the ACI:Lewis rat cardiac transplant model. Animals were fed ad libitum with either sta...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:

    authors: Levy AE,Alexander JW

    更新日期:1995-10-27 00:00:00

  • Relationship of cytomegalovirus viral load in blood to pneumonitis in lung transplant recipients.

    abstract::We developed a multiplex, quantitative, real-time, polymerase chain reaction assay for cytomegalovirus (CMV) and used it to measure the CMV viral load in weekly blood specimens from 43 lung transplant recipients. The median viral load in blood samples immediately preceding bronchoscopy was 1150 copies/microg human DNA...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/00007890-200108270-00030

    authors: Sanchez JL,Kruger RM,Paranjothi S,Trulock EP,Lynch JP,Hicks C,Shannon WD,Storch GA

    更新日期:2001-08-27 00:00:00

  • Major histocompatibility complex class I peptide-pulsed host dendritic cells induce antigen-specific acquired thymic tolerance to islet cells.

    abstract:BACKGROUND:As T-cell receptor-major histocompatibility complex (MHC) class I/self peptide interaction regulates T-cell development in the thymus, we reasoned that presentation of peptides by self dendritic cells (DC) to developing T cells in the thymus might induce acquired thymic tolerance. This hypothesis is based on...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/00007890-200001270-00005

    authors: Ali A,Garrovillo M,Jin MX,Hardy MA,Oluwole SF

    更新日期:2000-01-27 00:00:00

  • The role of pretransplant immunity in protection from cytomegalovirus disease following renal transplantation.

    abstract::To determine the extent to which pretransplant immunity resulting from natural infection protects against cytomegalovirus (CMV) disease, we analyzed CMV serology on 153 kidney donor and recipient pairs and followed transplant patients to determine incidence and severity of CMV disease. The overall incidence of CMV dis...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/00007890-198508000-00010

    authors: Smiley ML,Wlodaver CG,Grossman RA,Barker CF,Perloff LJ,Tustin NB,Starr SE,Plotkin SA,Friedman HM

    更新日期:1985-08-01 00:00:00

  • The role of donor-recipient relationship in long-term outcomes of living donor renal transplantation.

    abstract:BACKGROUND:Graft failure related to acute and chronic rejection remains an important problem in transplantation. An association has been reported between microchimerism and the development of tolerance. Since it has been established that cells of fetal origin can be found in maternal tissues long after parturition, and...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/TP.0b013e3181705a0f

    authors: Miles CD,Schaubel DE,Liu D,Port FK,Rao PS

    更新日期:2008-05-27 00:00:00

  • Favorable Kidney Function in Pediatric Liver Transplant Recipients: Results of a Single-center Cohort Study.

    abstract:BACKGROUND:Although chronic kidney disease (CKD) is still a common complication, the prognosis of kidney function after liver transplantation (LT) is not well known. Moreover, kidney function after LT in children with renal involvement is unknown. METHODS:We retrospectively analyzed patients aged <20 years who underwe...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/TP.0000000000002548

    authors: Sato M,Kaneko T,Ogura M,Kamei K,Ito S,Fukuda A,Sakamoto S,Kasahara M,Ishikura K

    更新日期:2019-08-01 00:00:00

  • Capacity of "transplanted" lymphocytes to traverse the intestinal epithelium of adult rats.

    abstract::Suspensions of viable lymph node cells (LNCs), both unlabeled and 3H-uridine labeled, from adult Fischer (FI) rats were inoculated into the lumens of established, surgically isolated segments of ileum in adult (FI x DA)F1 hybrid hosts. Vascular, lymphatic, and nerve supplies of the isolated segment were preserved. It ...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/00007890-198110000-00010

    authors: Seelig LL Jr,Billingham RE

    更新日期:1981-10-01 00:00:00

  • Comparison of activation requirements and activation phenotype of allogeneic and xenogeneic rodent responses in vivo and in vitro.

    abstract:BACKGROUND:Both discordant and concordant xenogeneic responses are dominated by humoral immunity. Recent advances in molecular engineering approaches may largely prevent rejection by means of this pathway, leaving the cellular arm of the immune response as the principal remaining barrier to successful engraftment. MET...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/00007890-200108150-00021

    authors: Trani JL,Song HK,Lerner SM,Markmann JW,Barker CF,Naji A,Markmann JF

    更新日期:2001-08-15 00:00:00

  • Inhibition of interferon-gamma-mediated microvascular endothelial cell major histocompatibility complex class II gene activation by HMG-CoA reductase inhibitors.

    abstract:BACKGROUND:Graft vascular disease, a major cause of late graft failure in cardiac transplant patients, is associated with the presence of class II major histocompatibility complex molecules on the endothelium. 3-hydroxy-3-methylglutaryl (HMG)-CoA reductase inhibitors, e.g., simvastatin, have been shown to reduce the in...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/00007890-200105150-00014

    authors: Sadeghi MM,Tiglio A,Sadigh K,O'Donnell L,Collinge M,Pardi R,Bender JR

    更新日期:2001-05-15 00:00:00

  • Differential regulation of the nuclear factor-κB pathway by rabbit antithymocyte globulins in kidney transplantation.

    abstract:BACKGROUND:Induction therapy is associated with excellent short-term kidney graft outcome. The aim of this study was to evaluate differences in the intragraft transcriptome after successful induction therapy using two rabbit antithymocyte globulins. METHODS:The expression of 376 target genes involved in tolerance, inf...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/TP.0b013e31824491aa

    authors: Urbanova M,Brabcova I,Girmanova E,Zelezny F,Viklicky O

    更新日期:2012-03-27 00:00:00

  • Nondepleting anti-CD4 monoclonal antibody enhances the ability of oral alloantigen delivery to induce indefinite survival of cardiac allografts: oral tolerance to alloantigen.

    abstract:BACKGROUND:We examined whether oral administration of alloantigen could induce the prolonged survival of cardiac allografts. METHODS:Hearts from CBK (H2k+Kb) transgenic or (C57BL/10xCBA)F1 (H2bxH2k) mice were transplanted into CBA (H2k) recipients pretreated orally with 1 x 10(7) donor splenocytes in the presence or a...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/00007890-200011270-00021

    authors: Niimi M,Witzke O,Bushell A,Hara M,Morris PJ,Wood KJ

    更新日期:2000-11-27 00:00:00

  • Impact of renal posttransplantation amputation on allograft outcomes: a study of United States renal data system.

    abstract:BACKGROUND:The prevalence of renal posttransplantation amputation and its impact on allograft and patient survival have not been widely reported. METHODS:We used an incident cohort of patients who underwent renal transplantation between June 2004 and September 2009. Amputation data were obtained using Medicare institu...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/TP.0b013e31828e72b4

    authors: Brar A,Jindal RM,Sumrani N,John D,Mondal Z,Tedla F,Salifu MO

    更新日期:2013-05-27 00:00:00

  • Corynebacterium liquefaciens-induced suppressor T cells in graft-versus-host reaction.

    abstract::The effect of the spleen cells and thymus cells from Corynebacterium liquefaciens-treated (C57BL/6 x BALB/c)F1 hybrid mice on graft-versus-host (GVH) reaction, initiated in the parental to newborn F1 hybrid strain combination, was studied by using Simonsen's spleen assay. The combined inocula of 5 x 10(6) normal BALB/...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/00007890-198001000-00009

    authors: Kobayashi M,Kawashima K,Yamada K

    更新日期:1980-01-01 00:00:00

  • Urine cytologic profile in renal allograft recipients determined by monoclonal antibodies. Diagnosis of allograft rejection.

    abstract::Controversy exists as to the type of cells present in the urine during renal allograft rejection. In order to resolve this controversy as well as to evaluate the value of urine sediment examination as a means of detecting AR, we quantitated the different cells present in urine during AR using an immunoperoxidase techn...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/00007890-198903000-00017

    authors: Segasothy M,Birch DF,Fairley KF,Kincaid-Smith P

    更新日期:1989-03-01 00:00:00

  • Cells mediating graft rejection in the mouse. II. The Ly phenotypes of cells producing tumor allograft rejection.

    abstract::The particular T cell subsets involved in the rejection of tumor allografts were examined in mice using two different approaches. In the first, EL4 lymphoma cells or B16 melanoma cells were given to ATXBM-CBA/H mice which had been reconstituted with either naive or sensitized T cells selectively depleted with either L...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/00007890-198202000-00013

    authors: Loveland BE,McKenzie IF

    更新日期:1982-02-01 00:00:00

  • The role of graft and host accommodation in a hamster-to-rat cardiac transplantation model.

    abstract:BACKGROUND:We evaluated the importance and mechanism of graft and host accommodation in hamster-to-rat cardiac xenotransplantation models. METHODS:To evaluate graft accommodation, accommodated hamster grafts (Group 2) were transplanted to naïve host rats treated with FK506, and compared with naïve hamster grafts (Grou...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/01.tp.0000296030.88283.92

    authors: Komori K,Fuchimoto Y,Morikawa Y,Obara H,Kawachi S,Tanabe M,Hoshino K,Shimazu M,Matsuzaki Y,Kitajima M

    更新日期:2008-01-15 00:00:00

  • Accommodation: does it apply to human leukocyte antigens?

    abstract::The term "accommodation" was invoked to describe endothelial cell resistance to antibody-mediated rejection after ABO-incompatible kidney or experimental xenograft transplantation. Currently, there is much interest in how to achieve successful human leukocyte antigen (HLA)-incompatible allograft transplantation in HLA...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/TP.0b013e31823f468c

    authors: Rose ML,West LJ

    更新日期:2012-02-15 00:00:00

  • Successful renovascular reconstruction for renal allografts with multiple renal arteries.

    abstract:BACKGROUND:Kidney grafts with multiple renal arteries have been considered a relative contraindication because of the increased risk of complications. In the present study, we retrospectively reviewed multiple renal artery reconstruction in kidney transplantation to elucidate the usefulness of these grafts. METHODS:Fr...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/01.TP.0000054461.57565.18

    authors: Makiyama K,Tanabe K,Ishida H,Tokumoto T,Shimmura H,Omoto K,Toma H

    更新日期:2003-03-27 00:00:00

  • Progression of renal dysfunction in cardiac transplantation after the introduction of everolimus in the immunosuppressive regime.

    abstract::The aim of this study was to analyze, in heart transplant patients, if renal function improvement after cyclosporine replacement by everolimus persists at the middle term and its predictors. We studied prospectively 56 patients in whom conversion was consecutively made. Forty-five patients completed the follow-up peri...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/TP.0b013e31819452ce

    authors: Moro López JA,Almenar L,Martínez-Dolz L,Sánchez-Lázaro I,Agüero J,Buendía F,Ortiz V,Salvador A

    更新日期:2009-02-27 00:00:00

  • Long-term regeneration of human epidermis on third degree burns transplanted with autologous cultured epithelium grown on a fibrin matrix.

    abstract:BACKGROUND:Extensive third degree burn wounds can be permanently covered by the transplantation of autologous cultured keratinocytes. Many modifications to Green and colleagues' original technique have been suggested, including the use of a fibrin matrix. However, the properties of the cultured cells must be assessed u...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/00007890-200012150-00009

    authors: Ronfard V,Rives JM,Neveux Y,Carsin H,Barrandon Y

    更新日期:2000-12-15 00:00:00