Abstract:
BACKGROUND:Long-term follow-up and management of donors was undertaken in a specialist kidney transplant unit in Pakistan to identify risk and prevent adverse outcomes in living related kidney donors. METHODS:In an observation cohort study between 1985 and 2012, 3748 donors were offered free medical follow-up and treatment 6 to 12 months after donation and annually thereafter. Each visit included history, physical examination, blood tests for renal, lipid, glucose profiles, and 24-hour urine for proteinuria and creatinine clearance. Preventive intervention was undertaken for new onset clinical conditions. Donor outcomes were compared with 90 nondonor healthy siblings matched for age, sex, and body mass index. RESULTS:Of the 3748 donors, 2696 (72%) were in regular yearly follow-up for up to 27 years (median, 5.6; interquartile range, 7.9). Eleven (0.4%) died 4 to 22 years after donation with all-cause mortality of 4.0/10 000 person years. Six (0.2%) developed end-stage renal disease 5 to 17 years after donation, (2.7/10 000 person years). Proteinuria greater than 1000 mg/24 hours developed in 28 patients (1%), hypertension in 371 patients (13.7%), and diabetes in 95 patients (3.6%). Therapeutic intervention-controlled protein was less than 1000 mg/24 hours, blood pressure was below 140/90 mm Hg, and glycemic control in 85% up to 15 years after onset. Creatinine clearance fell from 109.8 ± 22.3 mL/min per 1.73 m predonation to 78 ± 17 at 1 year, 84 ± 19 at 5 years, and 70 ± 20 at 25 years. Comparison of 90 nondonor sibling and donor pairs showed significantly higher fasting glucose and hypertension in nondonors. CONCLUSIONS:Long-term follow-up of donors has demonstrated end-stage renal disease in 0.6% at 25 years. Regular follow-up identified new onset of disease and allowed interventions that may have prevented adverse outcomes.
journal_name
Transplantationjournal_title
Transplantationauthors
Rizvi SA,Zafar MN,Jawad F,Aziz T,Hussain Z,Hashmi A,Hussain M,Akhtar F,Ahmed E,Naqvi R,Naqvi SAdoi
10.1097/TP.0000000000001075subject
Has Abstractpub_date
2016-06-01 00:00:00pages
1284-93issue
6eissn
0041-1337issn
1534-6080journal_volume
100pub_type
杂志文章相关文献
TRANSPLANTATION文献大全abstract:BACKGROUND:Early calcineurin inhibitor (CNI) withdrawal with mycophenolate mofetil (MMF) has not become routine practice, due to concerns about excess acute rejection. Therapeutic drug monitoring may be advantageous when the CNI or MMF is withdrawn. METHODS:This prospective, randomized, concentration-controlled withdr...
journal_title:Transplantation
pub_type: 杂志文章,随机对照试验
doi:10.1097/TP.0b013e31824ad60a
更新日期:2012-05-15 00:00:00
abstract::The development of organ preservation solutions has been primarily accomplished in whole organ animal models. This study examines the toxicity of commonly used organ preservation solutions on endothelial cells in vitro. Primary human umbilical-vein endothelial cell cultures were incubated at 4 degrees C in solutions o...
journal_title:Transplantation
pub_type: 杂志文章
doi:10.1097/00007890-199205000-00002
更新日期:1992-05-01 00:00:00
abstract:BACKGROUND:The short tolerable cold ischemia time and the importance of other risk factors have generally superseded the role of HLA matching in the allocation of donor hearts. Recent advances in the accuracy and time required to perform HLA typing and crossmatching, however, have led us to re-examine the United Networ...
journal_title:Transplantation
pub_type: 杂志文章,多中心研究
doi:10.1097/00007890-200005270-00038
更新日期:2000-05-27 00:00:00
abstract::Acute graft-versus-host disease (GVHD) has recently been associated with endothelial cell injury. The potential clinical significance was explored here in an autopsy review. Thirty-seven allogeneic bone marrow recipients were identified in the autopsy files at The Johns Hopkins Hospital with no evidence of systemic in...
journal_title:Transplantation
pub_type: 杂志文章
doi:10.1097/00007890-199401000-00016
更新日期:1994-01-01 00:00:00
abstract::The role of TNF in the expression of GVHD and GVHD-related immunodeficiency was studied in a well-established murine GVHD model of bone marrow transplantation across minor histocompatibility barriers (B10.BR-->GBA/J) both in vitro and in vivo. Splenocytes from animals with GVHD profoundly inhibited the proliferation o...
journal_title:Transplantation
pub_type: 杂志文章
doi:10.1097/00007890-199401001-00021
更新日期:1994-01-01 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 effect of cyclosporine A (CsA) on polyomavirus BK virus (BKV) replication remains unclear. The aim of this in vitro study was to investigate the effect of CsA on BKV replication in human uroepithelial cells. METHODS:After infection of a human renal proximal tubular cell line, HK-2 with BKV, BKV viral lo...
journal_title:Transplantation
pub_type: 杂志文章
doi:10.1097/TP.0b013e3181c9b51c
更新日期:2010-02-15 00:00:00
abstract::For many individuals suffering from end-stage liver disease (ESLD), the only treatment option is liver transplantation. However, liver transplant rejection is observed in 24-80% of transplant patients and lifelong drug regimens that follow the transplant procedure lead to serious side effects. Furthermore, the pool of...
journal_title:Transplantation
pub_type: 杂志文章
doi:10.1097/TP.0000000000003598
更新日期:2021-01-06 00:00:00
abstract:BACKGROUND:There are limited experimental data on the nature of the humoral response elicited in humans against pig antigens. In this study, we have examined the xenoantibody (XAb) response in eight patients with acute liver failure exposed to pig hepatocytes after treatment with the bioartificial liver (BAL). METHODS...
journal_title:Transplantation
pub_type: 杂志文章
doi:10.1097/00007890-199901150-00003
更新日期:1999-01-15 00:00:00
abstract::T lymphocyte subsets, mitogenic response, and immunoglobulin levels were studied in peripheral blood from 95 thalassemic patients before and at different times after bone marrow transplantation. With the exception of patients receiving more than 100 transfusion units before transplant, who showed an increased percenta...
journal_title:Transplantation
pub_type: 杂志文章
doi:10.1097/00007890-198809000-00012
更新日期:1988-09-01 00:00:00
abstract::Recent reports have demonstrated that humoral factors, especially antibodies elicited by xenoantigens, play an important role in the rejection of concordant cardiac xenografts. These induced antibodies, however, have not been well characterized. Therefore, we investigated the rejection mechanism, especially the role o...
journal_title:Transplantation
pub_type: 杂志文章
doi:
更新日期:1994-06-15 00:00:00
abstract::Erythropoietin (EPO) is widely used among patients with end-stage renal disease awaiting transplantation. Data suggest that EPO therapy may be immunomodulatory. The purpose of this study was to assess the effects of pretransplant EPO therapy on renal allograft outcome. We evaluated 120 consecutive renal transplant rec...
journal_title:Transplantation
pub_type: 临床试验,杂志文章
doi:10.1097/00007890-199610150-00024
更新日期:1996-10-15 00:00:00
abstract::Differentiation between rejection and infection of lung allografts remains difficult. The effects of these two pathologic entities on the cytolytic activity of bronchoalveolar lavage (BAL) and PBL were investigated. Left lung allotransplantation was performed on 16 mongrel dogs of which 12 were available for complete ...
journal_title:Transplantation
pub_type: 杂志文章
doi:10.1097/00007890-199306000-00008
更新日期:1993-06-01 00:00:00
abstract:BACKGROUND:It is imperative for healthcare providers to examine Western Muslim attitudes on organ donation, because they are reluctant donors. We explored such opinion with the aid of a quantitative survey. METHODS:Voluntary completion of an anonymous survey was promoted (online and paper sampling). For a population t...
journal_title:Transplantation
pub_type: 杂志文章
doi:10.1097/TP.0b013e318231ea17
更新日期:2011-11-27 00:00:00
abstract::Antibody-mediated injury is a major cause of allograft dysfunction and loss. Antibodies to ABH(O) blood group antigens are classic mediators of ABO-incompatible graft rejection, whereas donor-specific anti-HLA antibodies and, more recently, autoantibodies are appreciated as important contributors to allograft inflamma...
journal_title:Transplantation
pub_type: 杂志文章,评审
doi:10.1097/TP.0000000000001872
更新日期:2018-02-01 00:00:00
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...
journal_title:Transplantation
pub_type: 杂志文章
doi:10.1097/TP.0b013e3182590d6b
更新日期:2012-08-27 00:00:00
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...
journal_title:Transplantation
pub_type: 杂志文章
doi:10.1097/01.TP.0000089234.93366.6D
更新日期:2004-01-15 00:00:00
abstract:OBJECTIVE:The purpose of this study was to identify pretransplantation and posttransplantation indicators for the development of diabetes mellitus in the first 2 months after renal transplantation and to examine the influence of a cyclosporine A (CsA)-based versus a tacrolimus-based immunosuppressive regimen on these r...
journal_title:Transplantation
pub_type: 杂志文章
doi:10.1097/01.TP.0000084295.67371.11
更新日期:2003-11-15 00:00:00
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...
journal_title:Transplantation
pub_type: 杂志文章
doi:10.1097/00007890-199809150-00010
更新日期:1998-09-15 00:00:00
abstract::Infection remains one of the major complications of nonspecific immunosuppression in renal transplant patients and accounts for significant morbidity and mortality. The incidence of infectious complications has been shown to be related to the degree of immunosuppression and correlated with the total steroid dosage, us...
journal_title:Transplantation
pub_type: 杂志文章
doi:10.1097/00007890-199701150-00030
更新日期:1997-01-15 00:00:00
abstract::After measurement of normal renal function, dog kidneys (n = 52) were subjected to 3, 15, or 30 min of normothermic warm ischemia (WI). After 24 hr of preservation by simple hypothermic storage (SHS) in a modified Collins solution, autotransplant was done and renal function was again measured beginning at 1 hr. Compar...
journal_title:Transplantation
pub_type: 杂志文章
doi:10.1097/00007890-198611000-00003
更新日期:1986-11-01 00:00:00
abstract:BACKGROUND:The influence of the preservation solution used for in situ perfusion of the donor and pancreas storage on islet isolation has received little attention. METHODS:In this prospective controlled trial, we compared the outcome of human islet isolation from pancreata perfused with University of Wisconsin (UW) s...
journal_title:Transplantation
pub_type: 杂志文章
doi:10.1097/01.tp.0000251723.97483.16
更新日期:2007-02-15 00:00:00
abstract::Lamivudine combined with hepatitis B immune globulin (HBIg) is the standard of care for preventing the recurrence hepatitis B virus after liver transplant. To determine the risk of hepatitis B virus (HBV) recurrence after early withdrawal of HBIg in patients receiving lamivudine maintenance therapy, 20 patients receiv...
journal_title:Transplantation
pub_type: 杂志文章,随机对照试验
doi:10.1097/01.tp.0000277289.23677.0a
更新日期:2007-09-15 00:00:00
abstract::The association of renal vein thrombosis and membranous glomerulopathy in native kidneys has been well documented. However, this association has only occasionally been described following renal transplantation. A review of 693 renal transplant recipients revealed 77 (11%) in whom persistent, heavy proteinuria (greater...
journal_title:Transplantation
pub_type: 杂志文章
doi:
更新日期:1984-12-01 00:00:00
abstract:BACKGROUND:Liver transplantation is a widely accepted treatment for end-stage liver disease. The aim of our study was to investigate the imbalance between T helper type 17 (Th17) and CD4(+) CD25(+) Foxp3(+) regulatory T (Treg) cells during hepatic allograft rejection in a rodent grafts model because their roles in live...
journal_title:Transplantation
pub_type: 杂志文章
doi:10.1097/TP.0000000000000666
更新日期:2015-06-01 00:00:00
abstract::The effect of cyclosporine on hepatic ischemia was investigated. Hepatic ischemia was produced for 90 min in mongrel dogs. Experimental dogs were divided into three groups as follows: group A (control group), group B (CsA pretreatment group), group C (CsA posttreatment group). CsA was administered at a dose of 10 mg/k...
journal_title:Transplantation
pub_type: 杂志文章
doi:10.1097/00007890-199107000-00024
更新日期:1991-07-01 00:00:00
abstract::Although the cornea is considered to be an immunological privileged site, corneal transplantation can result in immunological rejection followed by graft failure, especially in patients with vascularized corneas. Several studies suggest a beneficial effect of matching for the HLA class I antigens on corneal graft surv...
journal_title:Transplantation
pub_type: 杂志文章
doi:10.1097/00007890-199504150-00021
更新日期:1995-04-15 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::Recent suggestions that the rat prostate is an alymphatic, immunologically privileged site stimulated further investigation of its status using a variety of techniques. Fixation of certain organs by vascular perfusion of glutaraldehyde followed by plastic embedding avoids the distortion and stromal reorganization that...
journal_title:Transplantation
pub_type: 杂志文章
doi:10.1097/00007890-197902000-00011
更新日期:1979-02-01 00:00:00
abstract::Second clinical kidney grafts often survive longer than first grafts. Using a rat cardiac allograft model, we examined the conditions under which survival of a second graft can be longer than first graft survival. In the BUF-to-LEW combination, following rejection of the first transplant, second cardiac allografts fro...
journal_title:Transplantation
pub_type: 杂志文章
doi:10.1097/00007890-199210000-00025
更新日期:1992-10-01 00:00:00