Abstract:
BACKGROUND:Patient-level risk factors for delayed graft function (DGF) have been well described. However, the Organ Procurement and Transplantation Network definition of DGF is based on dialysis in the first week, which is subject to center-level practice patterns. It remains unclear if there are center-level differences in DGF and if measurable center characteristics can explain these differences. METHODS:Using the 2003 to 2012 Scientific Registry of Transplant Recipients data, we developed a hierarchical (multilevel) model to determine the association between center characteristics and DGF incidence after adjusting for known patient risk factors and to quantify residual variability across centers after adjustment for these factors. RESULTS:Of 82,143 deceased donor kidney transplant recipients, 27.0% developed DGF, with a range across centers of 3.2% to 63.3%. A center's proportion of preemptive transplants (odds ratio [OR], 0.83; per 5% increment; 95% confidence interval [95% CI], 0.74-;0.93; P = 0.001) and kidneys with longer than 30 hr of cold ischemia time (CIT) (OR, 0.95; per 5% increment; 95% CI, 0.92-;0.98; P = 0.001) were associated with less DGF. A center's proportion of donation after cardiac death donors (OR, 1.12; per 5% increment; 95% CI, 1.03-;1.17; P < 0.001) and imported kidneys (OR, 1.06; per 5% increment; 95% CI, 1.03-;1.10; P < 0.001) were associated with more DGF. After patient-level and center-level adjustments, only 41.8% of centers had DGF incidences consistent with the national median and 28.2% had incidences above the national median. CONCLUSION:Significant heterogeneity in DGF incidences across centers, even after adjusting for patient-level and center-level characteristics, calls into question the generalizability and validity of the current DGF definition. Enhanced understanding of center-level variability and improving the definition of DGF accordingly may improve DGF's utility in clinical care and as a surrogate endpoint in clinical trials.
journal_name
Transplantationjournal_title
Transplantationauthors
Orandi BJ,James NT,Hall EC,Van Arendonk KJ,Garonzik-Wang JM,Gupta N,Montgomery RA,Desai NM,Segev DLdoi
10.1097/TP.0000000000000450subject
Has Abstractpub_date
2015-05-01 00:00:00pages
997-1002issue
5eissn
0041-1337issn
1534-6080journal_volume
99pub_type
杂志文章相关文献
TRANSPLANTATION文献大全abstract:BACKGROUND:Little is known about innate lymphoid cell (ILC) populations in the human gut, and the turnover of these cells and their subsets after transplantation has not been described. METHODS:Intestinal samples were taken from 4 isolated intestine and 3 multivisceral transplant recipients at the time of any operativ...
journal_title:Transplantation
pub_type: 杂志文章
doi:10.1097/TP.0000000000001593
更新日期:2017-10-01 00:00:00
abstract:BACKGROUND:Infants (<12 months) who require liver transplantation (LTx) represent a particularly challenging and understudied group of patients. METHODS:This retrospective study aimed to describe a large single-center experience of infants who received isolated LTx, illustrate important differences in infants versus o...
journal_title:Transplantation
pub_type: 杂志文章
doi:10.1097/TP.0b013e3181c5cdc1
更新日期:2010-03-15 00:00:00
abstract:BACKGROUND:The shortage of cadaveric livers has sparked an interest in adult-to-adult living donor transplantation. Right lobe donor hepatectomy is frequently required to obtain a graft of adequate size for adult recipients. Careful donor selection is necessary to minimize complications and assure a functional graft. ...
journal_title:Transplantation
pub_type: 杂志文章
doi:10.1097/00007890-200006150-00034
更新日期:2000-06-15 00:00:00
abstract::Noninvasive biomarkers are needed to monitor stable patients following kidney transplantation (KT), as subclinical rejection, currently detectable only with invasive surveillance biopsies, can lead to chronic rejection and graft loss. Several biomarkers have recently been developed to detect rejection in KT recipients...
journal_title:Transplantation
pub_type: 杂志文章
doi:10.1097/TP.0000000000003064
更新日期:2020-04-01 00:00:00
abstract::The generation of Gal knockout (KO) pigs is likely to be an important advance in xenotransplantation. However, recent reports suggesting that expression of Gal may not be completely eliminated raise the possibility of a continuing anti-Gal immune response. The authors used a Gal-mismatched skin graft model to study ce...
journal_title:Transplantation
pub_type: 杂志文章
doi:10.1097/01.tp.0000116420.17173.e4
更新日期:2004-03-15 00:00:00
abstract:INTRODUCTION:Posttransplant anemia and its association with transplant outcomes have not been properly studied. METHODS:We examined 530 renal allograft recipients transplanted at our center and followed up for 31.0±14.1 months. Hemoglobin (Hb), serum bicarbonate, and creatinine; use of erythropoiesis-stimulating agent...
journal_title:Transplantation
pub_type: 杂志文章
doi:10.1097/TP.0b013e31824b36fa
更新日期:2012-05-15 00:00:00
abstract::Sera obtained before transplantation from 52 consecutive renal allograft recipients were tested for antibody-dependent cell-mediated cytotoxicity (ADCC) and for complement-dependent cytotoxic antibodies (CDC). A D locus antigen-defined lymphoblastoid cell panel (B lymphoblastoid cell panel) was used as targets for the...
journal_title:Transplantation
pub_type: 杂志文章
doi:
更新日期:1979-05-01 00:00:00
abstract:BACKGROUND:The long-term metabolic function of microencapsulated xenogeneic adult porcine islets (API) was assessed in a murine model of type 1 diabetes mellitus. METHODS:API were encapsulated in barium-gelled alginate and transplanted intraperitoneally in diabetic nonobese diabetic (NOD) mice given no immunosuppressi...
journal_title:Transplantation
pub_type: 杂志文章
doi:10.1097/TP.0b013e3181abbfc1
更新日期:2009-07-27 00:00:00
abstract:BACKGROUND:Gene targeting in large animals has the potential to be useful in medicine as well as in agriculture. Previously, we reported the first successful targeting of the bovine alpha1,3-galactosyltransferase (alpha1,3GT) gene and establishment of a heterozygous knockout cell line. In this report, we generated both...
journal_title:Transplantation
pub_type: 杂志文章
doi:10.1097/01.tp.0000190422.66657.f1
更新日期:2006-03-15 00:00:00
abstract::SLT presents an interesting concept to alleviate the organ shortage for children with end-stage liver disease. The procedure has, however, not gained wide acceptance. This is not only related to the complexity of the procedure, but also to the poorer results and the complications reported on the right side graft. We r...
journal_title:Transplantation
pub_type: 杂志文章
doi:
更新日期:1995-04-27 00:00:00
abstract::In a prospective longitudinal study, detection of cytomegalovirus (CMV) DNA in plasma (plasma polymerase chain reaction [PCR]) was compared with PCR of CMV DNA in peripheral blood leukocytes (PBL PCR), the CMV pp65 antigenemia assay, and viral cultures from blood, urine, and throat of 29 patients, 14 of whom received ...
journal_title:Transplantation
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00007890-199707150-00020
更新日期:1997-07-15 00:00:00
abstract::In a randomized trial conducted in 9 Ontario transplant centers, 107 cadaver kidney donors were randomized so that both kidneys were preserved either by simple cold storage (CS) or by pulsatile perfusion (PP). After exclusions and losses to follow-up, there were 90 patients in the CS group and 91 in the PP group. Tota...
journal_title:Transplantation
pub_type: 临床试验,杂志文章,随机对照试验
doi:
更新日期:1987-06-01 00:00:00
abstract::The participation of an immunologically compatible donor-intended recipient pair in a kidney exchange that is unnecessary for them can significantly increase the number of kidneys available for transplantation. Despite their utilitarian value transplant ethicists have condemned this type of organ exchange as morally i...
journal_title:Transplantation
pub_type: 杂志文章
doi:10.1097/TP.0b013e3182047554
更新日期:2011-02-15 00:00:00
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
更新日期:2018-03-01 00:00:00
abstract:BACKGROUND:The management of small bowel transplantation is unique because signs of rejection can be obtained visually by endoscopy. The aim of this study was to evaluate the accuracy of endoscopic appearance in assessing histologic evidence of acute cellular rejection (ACR). METHODS:Endoscopies were performed in 66 a...
journal_title:Transplantation
pub_type: 杂志文章
doi:10.1097/TP.0b013e31825f4410
更新日期:2012-10-15 00:00:00
abstract:BACKGROUND:The use of anti-B-cell and T-cell immunosuppressive agents leads to only a few weeks' survival of mouse-to-rat cardiac xenografts. METHODS:BALB/c cardiac xenografts were transplanted to Lewis rats treated with cyclosporine (CsA) and/or cobra venom factor (CVF). RESULTS:CsA alone did not prolong xenograft s...
journal_title:Transplantation
pub_type: 杂志文章
doi:10.1097/00007890-199805150-00012
更新日期:1998-05-15 00:00:00
abstract:BACKGROUND:In Th (T helper) 1/Th2 balance in response to signals given during donor antigen presentation, induction of allograft prolongation is more often related to Th2-type than with Th1-type immunity. Here, we examined the effect of interleukin (IL)-33, a novel member of the IL-1 family, on cardiac allograft surviv...
journal_title:Transplantation
pub_type: 杂志文章
doi:10.1097/TP.0b013e3181d720af
更新日期:2010-05-27 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:BACKGROUND:Although the outcome of islet transplantation has improved, there remains a major obstacle in isolating viable islets from prolonged preserved pancreas. We previously reported that the two-layer cold storage method (TLM) improved the yield and in vitro function. In this study, we performed in vivo accurate f...
journal_title:Transplantation
pub_type: 杂志文章
doi:10.1097/01.tp.0000154914.34121.72
更新日期:2005-06-15 00:00:00
abstract::The nephrotoxic effects of cyclosporine (CsA) seem to be augmented by co-existing renal injury. A high rate of prolonged delayed function (acute tubular necrosis [ATN]) and non-function (NF) has been associated with the use of CsA prior to and following renal transplantation. Cyclosporine has also been associated with...
journal_title:Transplantation
pub_type: 杂志文章
doi:10.1097/00007890-198701000-00019
更新日期:1987-01-01 00:00:00
abstract::Transplant coronary artery disease and malignancy are the major limitations to survival after heart transplantation. In a randomized trial, mycophenolate mofetil (MMF) significantly improved 3-year survival over azathioprine, but the expected reduction in intracoronary ultrasound evidence of vasculopathy was not found...
journal_title:Transplantation
pub_type: 杂志文章,评审
doi:10.1097/01.tp.0000153302.27299.16
更新日期:2005-02-15 00:00:00
abstract:BACKGROUND:The clinical impact of chronic transplant glomerulopathy (CTG) on the outcome of kidney allograft receiving calcineurin inhibitors (CNIs) remains uncertain. A retrospective study of renal transplant recipients at Ospedale Maggiore of Milan was undertaken to evaluate the clinical outcome of patients with CTG....
journal_title:Transplantation
pub_type: 杂志文章
doi:10.1097/01.tp.0000181167.88133.d2
更新日期:2005-11-27 00:00:00
abstract::Nine recombinant H-2 mouse strains with crossovers in the I region between I-E-negative haplotypes f,q and I-E-positive haplotypes p,k were examined for I-E expression by microcytotoxicity dye exclusion assay. These recombinants were found to be negative for I-E expression. There are two possible genotypes in these re...
journal_title:Transplantation
pub_type: 杂志文章
doi:10.1097/00007890-198702000-00026
更新日期:1987-02-01 00:00:00
abstract::Two infants born to mothers who had been given a renal transplant and who were receiving azathioprine and prednisone have been followed up for over 2 years. Initially both had lower than normal lymphocyte counts and cortisol levels. Chromosomal aberrations similar to those found in the lymphocytes of the mothers were ...
journal_title:Transplantation
pub_type: 杂志文章
doi:10.1097/00007890-197604000-00004
更新日期:1976-04-01 00:00:00
abstract:BACKGROUND:Increasing use of kidney grafts for simultaneous liver and kidney (SLK) transplants is causing concern about the most effective utilization of scarce kidney graft resources. This study evaluated the impact of implementing the proposed United Network for Organ Sharing SLK transplant policy on outcomes for end...
journal_title:Transplantation
pub_type: 杂志文章
doi:10.1097/TP.0000000000000270
更新日期:2015-02-01 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
abstract::LEW rats with long-surviving (> 100 days) (DA x LEW)F1 kidney allografts were generated by treating the recipients with cyclosporine for 14 days after grafting. All rats were monitored after transplantation for the development of antibodies to intact donor class I MHC molecules. Cyclosporine completely suppressed the ...
journal_title:Transplantation
pub_type: 杂志文章
doi:10.1097/00007890-199605270-00007
更新日期:1996-05-27 00:00:00
abstract:BACKGROUND:A new vascularized concordant xenotransplant model using the Chinese hamster as donor and mouse as recipient species is reported. This model takes advantage of the wealth of informative immune reagents and knockout and transgenic backgrounds available for the mouse. METHODS:Heterotopic auxillary cardiac tra...
journal_title:Transplantation
pub_type: 杂志文章
doi:10.1097/00007890-199906150-00016
更新日期:1999-06-15 00:00:00
abstract::Cultured neonatal rat islets were transplanted across six strain combinations into nonimmunosuppressed allogeneic recipients. Islets were isolated nonenzymatically by an in vitro method and were cultured at 37 degrees C in 5% CO2 in air for 10 days prior to transplant. Transplants to nondiabetic recipients across four...
journal_title:Transplantation
pub_type: 杂志文章
doi:10.1097/00007890-198712000-00003
更新日期:1987-12-01 00:00:00
abstract::The effect of cyclosporine and metabolite 17 (M17) as well as other CsA-related compounds (CsG, dihydro-CsC, dihydro-CsD, CsH, B5.49, and H7.94) was tested on T lymphocyte clone proliferation. In these experiments, antigen and interleukin 2 (IL-2) dependent long-term T lymphocyte clones derived from a rejected human k...
journal_title:Transplantation
pub_type: 杂志文章
doi:10.1097/00007890-198712000-00019
更新日期:1987-12-01 00:00:00