Abstract:
BACKGROUND:Black kidney transplant recipients experience disproportionately high rates of graft loss. This disparity has persisted for 40 years, and improvements may be impeded based on the current public reporting of overall graft loss by US regulatory organizations for transplantation. METHODS:Longitudinal cohort study of kidney transplant recipients using a data set created by linking Veterans Affairs and US Renal Data System information, including 4918 veterans transplanted between January 2001 and December 2007, with follow-up through December 2010. Multivariable analysis was conducted using 2-stage joint modeling of random and fixed effects of longitudinal data (linear mixed model) with time to event outcomes (Cox regression). RESULTS:Three thousand three hundred six non-Hispanic whites (67%) were compared with 1612 non-Hispanic black (33%) recipients with 6.0 ± 2.2 years of follow-up. In the unadjusted analysis, black recipients were significantly more likely to have overall graft loss (hazard ratio [HR], 1.19; 95% confidence interval [95% CI], 1.07-1.33), death-censored graft loss (HR, 1.67; 95% CI, 1.45-1.92), and lower mortality (HR, 0.83; 95% CI, 0.72-0.96). In fully adjusted models, only death-censored graft loss remained significant (HR, 1.38; 95% CI, 1.12-1.71; overall graft loss [HR, 1.08; 95% CI, 0.91-1.28]; mortality [HR, 0.84; 95% CI, 0.67-1.06]). A composite definition of graft loss reduced the magnitude of disparities in blacks by 22%. CONCLUSIONS:Non-Hispanic black kidney transplant recipients experience a substantial disparity in graft loss, but not mortality. This study of US data provides evidence to suggest that researchers should focus on using death-censored graft loss as the primary outcome of interest to facilitate a better understanding of racial disparities in kidney transplantation.
journal_name
Transplantationjournal_title
Transplantationauthors
Taber DJ,Gebregziabher M,Payne EH,Srinivas T,Baliga PK,Egede LEdoi
10.1097/TP.0000000000001119subject
Has Abstractpub_date
2017-02-01 00:00:00pages
402-410issue
2eissn
0041-1337issn
1534-6080journal_volume
101pub_type
杂志文章相关文献
TRANSPLANTATION文献大全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::Invasive aspergillosis and mucormycosis are life-threatening infections in solid organ and hematopoietic cell transplant recipients. Despite medical advancements in the care of these patients and the availability of new mold-active drugs, the outcomes remain suboptimal. Therefore, there has been increased interest in ...
journal_title:Transplantation
pub_type: 杂志文章,评审
doi:10.1097/TP.0000000000002353
更新日期:2018-11-01 00:00:00
abstract:BACKGROUND:Transplant vasculopathy in kidney and heart allografts is associated with marked elevation of endothelin-1 (ET-1), but a role for ET-1 in the pathogenesis of transplant vasculopathy and chronic rejection has not been established. We, therefore, tested whether inhibition of ET-1-converting enzyme by phosphora...
journal_title:Transplantation
pub_type: 杂志文章
doi:10.1097/00007890-199906270-00007
更新日期:1999-06-27 00:00:00
abstract:BACKGROUND:Donor-specific immune tolerance has been reported in isolated cases of kidney transplantation associated with bone marrow transplantation. The following is a description of a living donor liver transplantation for a hilar cholangiocarcinoma in a previous recipient of an allogeneic bone marrow transplant. ME...
journal_title:Transplantation
pub_type: 杂志文章
doi:10.1097/01.TP.0000083981.82522.13
更新日期:2003-09-27 00:00:00
abstract:OBJECTIVE:We compared the enzyme release from preserved and ex vivo reperfused livers after acute injury or inflammatory stimulus with organ function. METHODS:Acute injury was induced by carbon tetrachloride and inflammation was induced by turpentine oil treatments. Livers were exsanguinated and preserved for 8 or 24 ...
journal_title:Transplantation
pub_type: 杂志文章
doi:10.1097/00007890-200210270-00004
更新日期:2002-10-27 00:00:00
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
更新日期:2000-11-27 00:00:00
abstract::The effects of FK506 on exocrine function of the pancreas in Sprague-Dawley rats were examined and compared with those of cyclosporine. FK506 did not affect the levels of amylase and lipase in the pancreas of rats given the drug orally in a daily dose of 1 or 5 mg/kg for 2 weeks. Furthermore, the pancreas of the rats ...
journal_title:Transplantation
pub_type: 杂志文章
doi:10.1097/00007890-199211000-00023
更新日期:1992-11-01 00:00:00
abstract:BACKGROUND:The clinical significance of HLA-directed antibodies newly detected after transplantation (HT) is controversial. METHODS:Seventy-one HT recipients consented to enroll. Mean follow-up time was 28 months (range 6-48). Panel reactive antibody (PRA) analysis was performed on posttransplant sera (2 weeks, 1, 2, ...
journal_title:Transplantation
pub_type: 杂志文章
doi:10.1097/01.tp.0000180564.14050.49
更新日期:2005-10-27 00:00:00
abstract:BACKGROUND:Acute kidney injury (AKI) after living donor liver transplantation (LDLT) is associated with increased mortality. We sought to identify associations between intraoperative hemodynamic variables and postoperative AKI. METHODS:We retrospectively reviewed 734 cases of LDLT. Intraoperative hemodynamic variables...
journal_title:Transplantation
pub_type: 杂志文章
doi:10.1097/TP.0000000000002584
更新日期:2019-09-01 00:00:00
abstract::The CD154-CD40 pathway is one of the critical costimulatory pathways that are required for full activation of T cells during alloimmune responses. Blockade of this pathway with anti-CD154 antibodies has been reported to prolong allograft survival in experimental transplantation models and to induce tolerance in some i...
journal_title:Transplantation
pub_type: 杂志文章,评审
doi:10.1097/00007890-200201151-00012
更新日期:2002-01-15 00:00:00
abstract::Phenotype, donor-specific cytolytic activity, and helper activity to release cytokines of cells infiltrating within renal allografts of hosts rendered unresponsive by perioperative administration of donor lymphocytes via the portal vein (p.v.) were investigated in order to analyze the mechanism of prolongation of allo...
journal_title:Transplantation
pub_type: 杂志文章
doi:10.1097/00007890-199001000-00038
更新日期:1990-01-01 00:00:00
abstract::We report the long-term follow-up (greater than 1 year) of 46 patients (12 pediatric) randomized to receive OKT3 for the first 14 days after OLT with low-dose steroids compared with 39 patients (8 pediatric) who received cyclosporine, steroids, and azathioprine. The mean period of follow-up for survivors was 648 +/- 2...
journal_title:Transplantation
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00007890-199107000-00019
更新日期:1991-07-01 00:00:00
abstract:INTRODUCTION:Some Indoasian (IA) patients with established renal failure travel abroad for commercial kidney transplantation. We compared the 1-year outcomes of IA patients from one UK region who received overseas transplants with IA patients receiving local living donor (LD) kidney transplantation, deceased donor (DD)...
journal_title:Transplantation
pub_type: 杂志文章
doi:10.1097/TP.0b013e3181da6019
更新日期:2010-06-27 00:00:00
abstract::In a DBA/2 (H-2d) pancreatic islet-to-B6AF1 (H-2b/k.d) recipient combination, the graft survival of hand-picked islets was compared with that of "crude digested" islets that were prepared simply by collagenase digestion and Ficoll gradient separation and were contaminated with lymph nodes and vascular and ductal tissu...
journal_title:Transplantation
pub_type: 杂志文章
doi:10.1097/00007890-198610000-00011
更新日期:1986-10-01 00:00:00
abstract:BACKGROUND:It is controversial whether coronary endothelial function is impaired after cold exposure to University of Wisconsin (UW) or St. Thomas' Hospital (ST) solution during heart transplantation. We therefore examined the effects of cold storage of coronary micro-arteries with UW or ST solution on endothelium-deri...
journal_title:Transplantation
pub_type: 杂志文章
doi:
更新日期:2000-07-15 00:00:00
abstract::Heterotopic renal allografts following bilateral nephrectomies were placed in 21 healthy mongrel dogs. One group of 11 dogs received cyclosporine (5 mg/kg/24 hr, orally), and 1 group of 10 dogs received cyclosporine and mizoribine (5 mg/kg and 3 mg/kg/24 hr, orally). Body weights, blood cell counts, serum chemistry pr...
journal_title:Transplantation
pub_type: 杂志文章
doi:10.1097/00007890-198805000-00003
更新日期:1988-05-01 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:Cyclosporine A (CsA)-associated oxidative stress has been proposed as an important mechanism of renal injury. This study was designed to examine whether N-acetylcysteine (NAC), a well-known antioxidant, affects Klotho, antiaging gene, expression and its signaling pathway in an experimental model of chronic C...
journal_title:Transplantation
pub_type: 杂志文章
doi:10.1097/TP.0b013e318296c9a9
更新日期:2013-07-27 00:00:00
abstract:BACKGROUND:To define whether immunosuppressive agents that block the interleukin (IL)-2 pathway could prevent activation-induced cell death of activated T cells in the graft, we measured expression of IL-2, IL-2 receptor alpha chain (CD25), IL-15, Fas, and Fas ligand by real time reverse transcription-polymerase chain ...
journal_title:Transplantation
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/01.TP.0000063937.53702.97
更新日期:2003-05-27 00:00:00
abstract::Graft-versus-host disease (GVHD) is a common complication of bone marrow transplantation and often involves the gastrointestinal system. It is unclear whether there can be severe enough damage by GVHD to permanently injure the bowel and thereby prevent mucosal regeneration. We describe a patient who had successful tre...
journal_title:Transplantation
pub_type: 杂志文章
doi:10.1097/00007890-199612150-00028
更新日期:1996-12-15 00:00:00
abstract::The beneficial effect of deoxyspergualin (DSG, NKT-01) on lethal graft-versus-host disease in mice has been studied in a major histoincompatible donor-recipient combination. Suppression of the effector mechanisms responsible for the lethal outcome in this GVHD model is also noted. This study reveals: (1) DSG has a mar...
journal_title:Transplantation
pub_type: 杂志文章
doi:10.1097/00007890-199103000-00032
更新日期:1991-03-01 00:00:00
abstract:BACKGROUND:Pneumocystis jirovecii pneumonia (PJP) is an important infection-related complication, whose mode of transmission remains uncertain. METHODS:We investigated a nosocomial cluster of 14 PJP cases (11 confirmed and 3 probable) in kidney transplant recipients using epidemiological and genotyping methods. RESUL...
journal_title:Transplantation
pub_type: 杂志文章
doi:10.1097/TP.0b013e3182384b57
更新日期:2011-12-27 00:00:00
abstract:BACKGROUND:Long-term survival and functions of encapsulated islet grafts need to be evaluated in the absence of immunosuppression. The present study aimed to assess the viability and functions of macroencapsulated islets grafted in nonhuman primates without immunosuppression for 1 year. METHODS:Islet transplantations ...
journal_title:Transplantation
pub_type: 杂志文章
doi:10.1097/TP.0b013e31829e26cf
更新日期:2013-10-15 00:00:00
abstract:BACKGROUND:Ex situ normothermic machine perfusion (NMP) can be used to assess viability of suboptimal donor livers before implantation. Our aim was to assess the diagnostic accuracy of bile biochemistry for the assessment of bile duct injury (BDI). METHODS:In a preclinical study, 23 human donor livers underwent 6 hour...
journal_title:Transplantation
pub_type: 杂志文章
doi:10.1097/TP.0000000000002500
更新日期:2019-07-01 00:00:00
abstract:BACKGROUND:The current shortage of organ donors has led many centers to use marginal and nonheart-beating donors (NHBDs). Recent research has implicated the infiltration of lymphocytes as an important mediator of ischemia-reperfusion injury (IRI). FTY720 is an immunosuppressant that promotes lymphocyte sequestration in...
journal_title:Transplantation
pub_type: 杂志文章
doi:10.1097/01.tp.0000269794.74990.da
更新日期:2007-07-27 00:00:00
abstract:BACKGROUND:IgG antibodies to HLA class I antigens can cause hyperacute rejection of renal allografts. Screening of sera from such transplant candidates is laborious, time-consuming, and expensive when performed by sensitive antihuman globulin-augmented lymphocytotoxicity (AHG-CDC). METHODS:Because 60-70% of our transp...
journal_title:Transplantation
pub_type: 临床试验,杂志文章
doi:10.1097/00007890-199712150-00023
更新日期:1997-12-15 00:00:00
abstract::Polyclonal rabbit antirat thymocyte serum (ATS) has been shown to form in situ glomerular immune aggregates following perfusion into normal rat kidney ex vivo. This may be due to the presence of T-cell-like epitopes in the rat kidney, or it may be a result of contaminating anti-connective-tissue antibodies in ATS. To ...
journal_title:Transplantation
pub_type: 杂志文章
doi:10.1097/00007890-198606000-00015
更新日期:1986-06-01 00:00:00
abstract::Sera were obtained from 48 gravida II prenatal and 211 multiparous nonpregnant females and examined for leukocyte antibodies comparing a standard lymphocytotoxicity (CY) test with capillary agglutination (CA). Antibody was detected in 41% of the samples in both groups but only CA tests were positive with approximately...
journal_title:Transplantation
pub_type: 杂志文章
doi:10.1097/00007890-197602000-00001
更新日期:1976-02-01 00:00:00
abstract::Significant extended survival of C3H/He skin grafts in antilymphocyte serum (ALS)-treated B6AF1 mice can be brought about by the injection of donor-strain bone marrow on day 6 or 7 after grafting. In the present study, survival of the active graft-prolonging bone marrow cells under several storage conditions was inves...
journal_title:Transplantation
pub_type: 杂志文章
doi:10.1097/00007890-198601000-00004
更新日期:1986-01-01 00:00:00
abstract::The graft-versus-host (GVH) reaction induces thymic dysplasia and an arrest in T cell differentiation. Studies were performed to test the effect of irradiation and reconstitution with bone marrow on GVH-induced thymic dysplasia and T cell differentiation. GVH reactions were induced in CBAxAF1 adult mice by the injecti...
journal_title:Transplantation
pub_type: 杂志文章
doi:
更新日期:1984-03-01 00:00:00