Use of Elderly Allografts in Liver Transplantation.

Abstract:

INTRODUCTION:The use of liver allografts from elderly donors (≥70 years) has increased because of organ shortage and increased life expectancy. The aim of this study is to evaluate the current utilization of elderly donors in United States, recipient selection, and their posttransplant outcomes. METHODS:A linkage between Scientific Registry of Transplant Recipients and University HealthSystem Consortium databases was performed. Between January 2007 and December 2011, 12,445 liver transplant (LT) recipients were identified and divided into 2 cohorts based on donor age: 70 years or older (n = 540) and younger than 60 years (n = 10,473). RESULTS:Elderly donors accounted for 4.3% of all donors used in the 5-year period. When compared to younger donors, elderly donors were more likely to be women, shared regionally or nationally, and used at higher volume centers. Elderly donor allografts were less likely to be used in recipients with model of end-stage liver disease score higher than 27 (13.2% vs. 23.0%, P < 0.001), hospitalized (16.8% vs. 21.7%, P = 0.03), or on hemodialysis at time of transplant (2.6% vs. 8.2%, P < 0.001). Both recipient groups had similar perioperative mortality, 30-day readmission rates, and short-term patient survival. In the multivariate analysis, including recipient, donor, center and regional factors, donor age 70 years or older was associated with slightly increased risk of graft loss (hazard ratio, 1.3; 95% confidence interval, 1.08-1.56; P = 0.005). CONCLUSIONS:The current trend toward the use of elderly donors in liver transplant recipients with low model of end-stage liver disease scores (<27), without hepatitis C, not hospitalized and not on dialysis, is associated with acceptable perioperative outcomes, patient survival, and slightly worse graft survival.

journal_name

Transplantation

journal_title

Transplantation

authors

Paterno F,Wima K,Hoehn RS,Cuffy MC,Diwan TS,Woodle SE,Abbott DE,Shah SA

doi

10.1097/TP.0000000000000806

subject

Has Abstract

pub_date

2016-01-01 00:00:00

pages

153-8

issue

1

eissn

0041-1337

issn

1534-6080

journal_volume

100

pub_type

杂志文章
  • Ganciclovir resistance as a result of oral ganciclovir in a heart transplant recipient with multiple human cytomegalovirus strains in blood.

    abstract:BACKGROUND:The emergence of a ganciclovir (GCV)-resistant human cytomegalovirus (HCMV) strain in a heart transplant recipient (HTR) coinfected by multiple HCMV strains was investigated. METHODS:A HTR with primary HCMV infection was treated with three induction courses of intravenous GCV followed by a 2-month maintenan...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/00007890-199808150-00008

    authors: Baldanti F,Simoncini L,Sarasini A,Zavattoni M,Grossi P,Revello MG,Gerna G

    更新日期:1998-08-15 00:00:00

  • ISHLT Primary Graft Dysfunction Incidence, Risk Factors, and Outcome: A UK National Study.

    abstract:BACKGROUND:Heart transplantation (HTx) remains the most effective long-term treatment for advanced heart failure. Primary graft dysfunction (PGD) continues to be a potentially life-threatening early complication. In 2014, a consensus statement released by International Society for Heart and Lung Transplantation (ISHLT)...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/TP.0000000000002220

    authors: Avtaar Singh SS,Banner NR,Rushton S,Simon AR,Berry C,Al-Attar N

    更新日期:2019-02-01 00:00:00

  • The Impact of Performance Status on Length of Hospital Stay and Clinical Complications Following Liver Transplantation.

    abstract:BACKGROUND:Impaired pretransplant performance status (PS) is associated with chronic liver disease (CLD). We studied its impact on hospital length of stay (LOS), complications and readmissions in the first year after liver transplantation. METHOD:The Standard National Liver Transplant Registry was linked to a hospital...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/TP.0000000000003484

    authors: Wallace D,Cowling TE,Walker K,Suddle A,Gimson A,Rowe I,Callaghan C,Heaton N,van der Meulen J,Bernal W

    更新日期:2020-10-08 00:00:00

  • Improved phagocyte response by co-amoxiclav in renal transplant recipients.

    abstract:BACKGROUND:Infectious diseases are a major source of morbidity and mortality for immunosuppressed transplant recipients and the antimicrobial chemotherapy can be often less effective in these individuals, because the contribution of underlying host defenses is absent. METHODS:The influence of co-amoxiclav on the funct...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/00007890-200102270-00016

    authors: Cuffini AM,Tullio V,Giacchino F,Bonino A,Mandras N,Bianchi N,Roana J,Scalas D,Bonello F,Carlone NA

    更新日期:2001-02-27 00:00:00

  • Introducing hand-assisted retroperitoneoscopic live donor nephrectomy: learning curves and development based on 413 consecutive cases in four centers.

    abstract:BACKGROUND:Hand-assisted and retroperitoneoscopic techniques reduce the risk of bleeding and intraabdominal complications in living donor nephrectomy (LDN). This study reports on our four-center experience, development, and learning curves from the first 413 LDNs using a hand-assisted retroperitoneoscopic (HARS) techni...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/TP.0b013e3182052baf

    authors: Wadström J,Biglarnia A,Gjertsen H,Sugitani A,Fronek J

    更新日期:2011-02-27 00:00:00

  • First in man renal transplantation after ex vivo normothermic perfusion.

    abstract:BACKGROUND:Normothermic perfusion is an alternative but little studied method of organ preservation. Herein, we report the first case of ex vivo normothermic renal transplant perfusion in man. METHODS:The 62-year-old extended criteria donor died of an intracranial hemorrhage and had undergone cardiopulmonary resuscita...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/TP.0b013e31822d4e04

    authors: Hosgood SA,Nicholson ML

    更新日期:2011-10-15 00:00:00

  • A randomized controlled trial of intravenous or oral iron for posttransplant anemia in kidney transplantation.

    abstract:BACKGROUND:Anemia after kidney transplantation has been associated with poor transplant outcomes. We hypothesized that intravenous (IV) iron may more rapidly correct anemia than oral (PO) iron. METHODS:One hundred four kidney transplant recipients were prospectively randomized to IV iron polymaltose (500 mg single dos...

    journal_title:Transplantation

    pub_type: 杂志文章,随机对照试验

    doi:10.1097/TP.0b013e318248375a

    authors: Mudge DW,Tan KS,Miles R,Johnson DW,Badve SV,Campbell SB,Isbel NM,van Eps CL,Hawley CM

    更新日期:2012-04-27 00:00:00

  • Limb allografts in rats immunosuppressed with FK506. I. Reversal of rejection and indefinite survival.

    abstract::We have tested the effects of FK506 (FK), a new immunosuppressive agent, on a rat limb allograft model. Histoincompatible BN limb allografts were rejected in untreated F344 hosts within 11 +/- 1 days (mean +/- SD) after operation. A single injection of 2 mg/kg, 10 mg/kg, or 50 mg/kg of FK on the day of limb transplant...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/00007890-198911000-00011

    authors: Arai K,Hotokebuchi T,Miyahara H,Arita C,Mohtai M,Sugioka Y,Kaibara N

    更新日期:1989-11-01 00:00:00

  • In vivo immunoadsorption of antipig antibodies in baboons using a specific Gal(alpha)1-3Gal column.

    abstract::The major role of anti-alphaGal antibodies in the hyperacute rejection of pig organs by humans and baboons has been clearly demonstrated. Spacered alpha-galactose disaccharide (Gal(alpha1)-3Gal) hapten was produced by chemical synthesis and covalently attached to a flexible, hydrophilic polymer (PAA), which in turn wa...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/00007890-199611270-00001

    authors: Taniguchi S,Neethling FA,Korchagina EY,Bovin N,Ye Y,Kobayashi T,Niekrasz M,Li S,Koren E,Oriol R,Cooper DK

    更新日期:1996-11-27 00:00:00

  • Rejection of murine cardiac allografts. II. Evidence that splenocytes bearing Lyt2 inhibit responsiveness in long-term heart graft recipients.

    abstract::Mixed lymphocyte culture--lymphocyte-mediated cytotoxicity (MLC-LMC) reactions by recipient spleen cells were strongly and specifically increased shortly after primarily vascularized heart grafts were placed in mice. Subsequently, in strain combinations in which eventual long-term graft survival occurred, the MLC-LMC ...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:

    authors: Burdick JF,Clow LW

    更新日期:1987-04-01 00:00:00

  • Tissue-Resident Lymphocytes in Solid Organ Transplantation: Innocent Passengers or the Key to Organ Transplant Survival?

    abstract::Short-term outcomes of solid organ transplantation have improved dramatically over the past several decades; however, long-term survival has remained static over the same period, and chronic rejection remains a major cause of graft failure. The importance of donor, or "passenger," lymphocytes to the induction of toler...

    journal_title:Transplantation

    pub_type: 杂志文章,评审

    doi:10.1097/TP.0000000000002001

    authors: Prosser AC,Kallies A,Lucas M

    更新日期:2018-03-01 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

  • The effect of chronic graft-versus-host disease on B cell development.

    abstract::Chronic graft-versus-host disease often results in a combined deficiency of humoral and cell-mediated immunity. Clinical and experimental studies have suggested that the decrease in B cell responsiveness is due to a failure of B cell production in the bone marrow, intrinsic B cell defects, excessive suppressor T cell ...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/00007890-199303000-00025

    authors: Schreiber KL,Forman J

    更新日期:1993-03-01 00:00:00

  • Thymoglobulin induction decreases rejection in solitary pancreas transplantation.

    abstract:BACKGROUND:Solitary pancreas transplants, both pancreas transplant alone (PTA) and pancreas after kidney (PAK), have higher rejection rates and lower graft survivals than simultaneous pancreas-kidney transplants (SPK). The aim of this study is to compare three different antibody induction regimens in solitary pancreas ...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/00007890-200111270-00017

    authors: Stegall MD,Kim DY,Prieto M,Cohen AJ,Griffin MD,Schwab TR,Nyberg SL,Velosa JA,Gloor JM,Innocenti F,Bohorquez H,Dean PG,Carpenter HA,Leontovich ON,Sterioff S,Larson TS

    更新日期:2001-11-27 00:00:00

  • Mapping and transcriptional properties of RT1 class II region genes.

    abstract::The class II region of major histocompatibility complex of the rat. Rattus norvegicus (RT1) consists of RT1.B, RT1.D, and RT1.H subregions. The gene order around the H subregion was determined as RT1.A--H beta-H alpha--B by RFLP analysis of naturally occurring intra-RT1 recombinant rats with HLA DP probes. A unique re...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/00007890-199108000-00035

    authors: Fujii H,Kakinuma M,Yoshiki T,Natori T

    更新日期:1991-08-01 00:00:00

  • Infection with human herpesvirus 8 and transplant-associated gammopathy.

    abstract:BACKGROUND:The role of human herpesvirus (HHV)-8 in the pathogenesis of multiple myeloma and its pre-malignant state of monoclonal gammopathy is unclear. HHV-8 is transmitted by organ transplantation, representing a unique model with which to investigate primary HHV-8 infection. METHODS:The authors studied the inciden...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/01.tp.0000129065.31427.96

    authors: Regamey N,Hess V,Passweg J,Hess C,Steiger J,Erb P,Cathomas G,Tamm M

    更新日期:2004-05-27 00:00:00

  • Donor species complement after liver xenotransplantation. The mechanism of protection from hyperacute rejection.

    abstract::Hamster hearts transplanted into stable rat recipients of hamster livers (OLT rats) were hyperacutely rejected after transfer with unaltered rat antihamster hyperimmune serum (HS). This was followed by immediate liver xenograft rejection in 4 of 5 rats. In contrast, simple heat inactivation of the rat HS resulted in p...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/00007890-199403270-00025

    authors: Valdivia LA,Fung JJ,Demetris AJ,Celli S,Pan F,Tsugita M,Starzl TE

    更新日期:1994-03-27 00:00:00

  • A possible predictive test for graft-versus-host disease in bone marrow graft recipients: the mixed-epidermal cell-lymphocyte reaction.

    abstract::The possible ability of the mixed-epidermal-cell-lymphocyte reaction (MECLR) to detect alloreactivities in HLA-identical MLR negative siblings has been investigated before grafting in 30 donor-recipients pairs and their families. Results indicate that recipients' epidermal cells (EC) can induce proliferative responses...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/00007890-198603000-00007

    authors: Bagot M,Cordonnier C,Tilkin AF,Heslan M,Vernant JP,Dubertret L,Levy JP

    更新日期:1986-03-01 00:00:00

  • A predictive test for the efficacy of intravenous immunoglobulin in the inhibition of alloantibodies.

    abstract::Preformed recipient HLA-specific antibodies can cause hyperacute rejection of a transplanted kidney if they are directed against mismatched donor HLA antigens. To avoid hyperacute rejection it is essential that recipient antibodies be identified during patient workup for transplantation and HLA antigens to which a pat...

    journal_title:Transplantation

    pub_type: 评论,杂志文章

    doi:10.1097/00007890-200105270-00002

    authors: Martin S

    更新日期:2001-05-27 00:00:00

  • Donor brain death aggravates chronic rejection after lung transplantation in rats.

    abstract:BACKGROUND:Many recipients of lung transplants from brain-dead donors develop bronchiolitis obliterans, a manifestation of chronic rejection. It has been shown that brain death increases inflammatory mediators and accelerates acute rejection in kidney, liver, and heart transplants. In this study, the authors investigat...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/01.tp.0000142679.45418.96

    authors: Zweers N,Petersen AH,van der Hoeven JA,de Haan A,Ploeg RJ,de Leij LF,Prop J

    更新日期:2004-11-15 00:00:00

  • Functional impairment of enteric smooth muscle and nerves caused by chronic intestinal allograft rejection regresses after FK506 rescue.

    abstract::We have previously demonstrated that subclinical chronic rejection (CR) induces structural and functional alterations in enteric smooth muscle and nerves in a rat model of small intestinal transplantation. This study was designed to investigate the effect of prolonged FK506 rescue therapy on these sequelae of CR. Immu...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:

    authors: Heeckt PF,Lee KK,Halfter WM,Schraut WH,Bauer AJ

    更新日期:1995-01-27 00:00:00

  • Subclinical Antibody-mediated Rejection After Kidney Transplantation: Treatment Outcomes.

    abstract:BACKGROUND:Antibody-mediated rejection (AMR) is a leading cause of morbidity and mortality after kidney transplantation. Early diagnosis and treatment of subclinical AMR based on the donor-specific antibody (DSA) testing may result in better outcomes. METHODS:We tested this hypothesis in 220 kidney transplant recipien...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/TP.0000000000002566

    authors: Parajuli S,Joachim E,Alagusundaramoorthy S,Blazel J,Aziz F,Garg N,Muth B,Mohamed M,Mandelbrot D,Zhong W,Djamali A

    更新日期:2019-08-01 00:00:00

  • Tuberculosis in lung transplant recipients.

    abstract:BACKGROUND:Post-lung transplant infection is one of the leading causes of morbidity and mortality. The cause and incidence are similar in many series; however, infections such as Mycobacterium tuberculosis are influenced by the epidemiologic situation. The authors present a prospective and observational study to define...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/01.tp.0000147784.53188.dc

    authors: Bravo C,Roldán J,Roman A,Degracia J,Majo J,Guerra J,Monforte V,Vidal R,Morell F

    更新日期:2005-01-15 00:00:00

  • Immunoprotection and Functional Improvement of Allogeneic Islets in Diabetic Mice, Using a Stable Indoleamine 2,3-Dioxygenase Producing Scaffold.

    abstract:BACKGROUND:We have previously shown that an immunomodulatory enzyme, indoleamine 2,3-dioxygenase (IDO) in dermal fibroblasts generates a tryptophan-deficient environment that selectively inhibits proliferation and induces apoptosis of bystander CD4+ and CD8+ T cells, but not pancreatic islets. Because these immune cell...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/TP.0000000000000661

    authors: Hosseini-Tabatabaei A,Jalili RB,Khosravi-Maharlooei M,Hartwell R,Kilani RT,Zhang Y,Ghahary A

    更新日期:2015-07-01 00:00:00

  • Assessing renal function with daclizumab induction and delayed tacrolimus introduction in liver transplant recipients.

    abstract:BACKGROUND:Calcineurin inhibitor-induced renal dysfunction is a major problem in liver transplantation. Interleukin-2 receptor antagonist induction followed by delayed tacrolimus (Tac) administration may minimize the renal insult without compromising immunoprotection. METHODS:This open, randomized, multicenter trial e...

    journal_title:Transplantation

    pub_type: 杂志文章,多中心研究,随机对照试验

    doi:10.1097/TP.0b013e3181db8cf0

    authors: Calmus Y,Kamar N,Gugenheim J,Duvoux C,Ducerf C,Wolf P,Samuel D,Vanlemmens C,Neau-Cransac M,Salamé E,Chazouillères O,Declerck N,Pageaux GP,Dubel L,Rostaing L

    更新日期:2010-06-27 00:00:00

  • Renal Transplantation From Pediatric Donors in the United Kingdom.

    abstract:BACKGROUND:Significant disparity exists in the United Kingdom between the need for organ transplant and supply of deceased donor organs. In the recent years, efforts to increase donation has improved the rate of mainly deceased donors after circulatory death and from older donors. The rate of donation from pediatric po...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/TP.0000000000000575

    authors: Dave RV,Hakeem AR,Dawrant MJ,Ecuyer CL,Lewington AJ,Attia MS,Hostert L,Finlay E,Ahmad N

    更新日期:2015-09-01 00:00:00

  • Transplantomics: Toward Precision Medicine in Transplantation Research.

    abstract::Precision medicine is an emerging integrative approach for disease prevention, early detection, and treatment which takes into account individual variability in genetic and other molecular measurements, medical history, environmental exposures, and lifestyle. The development and availability of genomic and other molec...

    journal_title:Transplantation

    pub_type: 杂志文章,评审

    doi:10.1097/TP.0000000000001664

    authors: Sirota M,Sarwal MM

    更新日期:2017-08-01 00:00:00

  • Failure of T and B cell cooperation during graft-versus-host disease.

    abstract::Possible explanations for the immune deficiency usually associated with graft-versus-host disease include defective lymphocyte differentiation and active suppressor cell mechanisms. The present observations in a patient with chronic graft-versus-host disease delineate yet another possible mechanism: a failure of succe...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/00007890-198101000-00011

    authors: Dosch HM,Gelfand EW

    更新日期:1981-01-01 00:00:00

  • Posttransplant deaths and factors that influence the mortality rate in North American children.

    abstract::Of 2457 patients in the North American Pediatric Renal Transplant Cooperative Study registry who were followed for 5481 patient-years after the index transplantation, we observed 136 deaths, for an average annual rate of 24.8 deaths per 1000 patient-years. Death resulted primarily from infection (n = 55, 40%), cardiov...

    journal_title:Transplantation

    pub_type: 杂志文章,多中心研究

    doi:

    authors: Tejani A,Sullivan EK,Alexander S,Fine R,Harmon W,Lilienfeld D

    更新日期:1994-02-27 00:00:00

  • Absorption of shed I-Ak and H-2Kk antigens by lymphoid cells.

    abstract::The fate of cell surface I-Ak and H-2Kk antigens shed by murine spleen cells in culture was studied by incubation of nonlabeled spleen cells or splenic T or B cells with culture fluids containing shed radiolabeled alloantigens. Approximately 30 to 40% of the shed alloantigens could be absorbed by syngeneic or allogene...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/00007890-198201000-00008

    authors: Emerson SG,Cone RE

    更新日期:1982-01-01 00:00:00