Abstract:
BACKGROUND:Waiting time to deceased donor kidney transplant varies greatly across the United States. This variation violates the final rule, a federal mandate, which demands geographic equity in organ allocation for transplantation. METHODS:Retrospective analysis of the United States Renal Data System and United Network for Organ Sharing database from 2000 to 2009. Median waiting time was calculated for each of the 58 donor service areas (DSA) in the United States. Multivariate regression was performed to identify DSA predictors for long waiting times to kidney transplantation. RESULTS:The median waiting time varied between the 58 DSAs from 0.61 to 4.57 years, ranging from 0.59 to 5.17 years for standard criteria donor kidneys and 0.41 to 4.69 years for expanded criteria donor kidneys. The disparity in waiting time between the DSAs grew from 3.26 years (range, 0.41-3.67) in 2000 to 4.72 years (range, 0.50-5.22) in 2009. In DSAs with longer waiting times, there were significantly more patients suffering from end-stage renal disease and more patients listed for kidney transplant, lower kidney procurement rates, and higher transplant center competition. Patients were more likely black, sensitized, with lower educational attainment and less likely to waitlist outside of their DSA of residence. Donor organs used in DSAs with long waiting times were more likely hepatitis C positive and had a higher kidney donor profile index. Graft and patient survival at 5 years was worse for deceased donor kidney transplant, but rates for living donor kidney transplant were higher. CONCLUSION:Our analysis demonstrates significant and worsening geographic disparity in waiting time for kidney transplant across the DSAs. Increase in living donor kidney transplant and use of marginal organs has not mitigated the disparity. Changes to the kidney allocation system might be required to resolve this extensive geographic disparity in kidney allocation.
journal_name
Transplantationjournal_title
Transplantationauthors
Davis AE,Mehrotra S,McElroy LM,Friedewald JJ,Skaro AI,Lapin B,Kang R,Holl JL,Abecassis MM,Ladner DPdoi
10.1097/01.tp.0000438623.89310.dcsubject
Has Abstractpub_date
2014-05-27 00:00:00pages
1049-57issue
10eissn
0041-1337issn
1534-6080journal_volume
97pub_type
杂志文章,多中心研究相关文献
TRANSPLANTATION文献大全abstract:BACKGROUND:In response to a longstanding Federal mandate to minimize the role of geography in access to transplant in the United States, we assessed whether patient travel distance was associated with lung transplant outcomes. We focused on the posttransplant time period, when the majority of patient visits to a transp...
journal_title:Transplantation
pub_type: 杂志文章
doi:10.1097/TP.0000000000003129
更新日期:2020-11-01 00:00:00
abstract:BACKGROUND:Activation of the renin angiotensin system may contribute to the development of delayed graft function after renal transplantation. We, therefore, examined the impact of pretransplant treatment with blockers of the renin angiotensin system on early graft function after renal transplantation. METHOD:The case...
journal_title:Transplantation
pub_type: 杂志文章
doi:10.1097/TP.0b013e3181c892f2
更新日期:2010-03-27 00:00:00
abstract:BACKGROUND:Encapsulated cell therapy might be a promising approach to enable cell transplantation without immunosuppression. This study investigates the viability and hepatic function of hepatocytes encapsulated with alginate/poly-L-lysine in vitro and the effect of the intrasplenic transplantation of cultured encapsul...
journal_title:Transplantation
pub_type: 杂志文章
doi:10.1097/01.tp.0000156319.47645.3b
更新日期:2005-04-15 00:00:00
abstract::The case studies of four patients with post-transplantation calcinosis are presented. Three of the four patients died of inanition and sepsis secondary to infection of extensive soft tissue ulcers and diffuse cutaneous vascular calcification with gangrene. The fourth patient survived following removal of all four para...
journal_title:Transplantation
pub_type: 杂志文章
doi:10.1097/00007890-197901000-00006
更新日期:1979-01-01 00:00:00
abstract:BACKGROUND:Transplant medicine's impact on America's public health is seriously limited by acute shortage of transplantable organs. Consequently, the United Sates has witnessed considerable investment in the promotion of organ donor registries. Although there is no evidence to support that donor registry promotion alle...
journal_title:Transplantation
pub_type: 杂志文章
doi:10.1097/TP.0000000000000957
更新日期:2016-06-01 00:00:00
abstract:BACKGROUND:The leflunomide analog, FK778, is a selective pyrimidine synthesis inhibitor. In rodent models, FK778 is efficacious in the prevention of allograft and xenograft rejection, and a combination of FK778 and cyclosporine has synergistic immunosuppressive efficacy. METHODS:Heterotopic renal transplantation was p...
journal_title:Transplantation
pub_type: 杂志文章
doi:10.1097/01.TP.0000061789.97072.12
更新日期:2003-04-27 00:00:00
abstract:BACKGROUND:The long-term outcome of lung transplantation is impeded by the development of obliterative bronchiolitis (OB). We sought to investigate the relationship between the apoptosis of tracheal epithelial cells and bone marrow-derived myofibroblasts in the process of OB. METHODS:The mouse orthotopic tracheal tran...
journal_title:Transplantation
pub_type: 杂志文章
doi:10.1097/TP.0000000000001230
更新日期:2016-09-01 00:00:00
abstract:BACKGROUND:At our transplant center, cardiac allograft recipients undergo transplantation following a negative IgG anti-human globulin (AHG) crossmatch (XM). Flow cytometry crossmatching (FCXM) is a more sensitive XM procedure than the AHG XM procedure, yet there is limited information regarding the clinical relevance ...
journal_title:Transplantation
pub_type: 杂志文章
doi:10.1097/00007890-199901270-00012
更新日期:1999-01-27 00:00:00
abstract::The incidence of interstitial pneumonitis (IP) was reviewed in 70 consecutive patients who received autologous marrow transplants for hematologic malignancies. All patients were treated with total-body irradiation (TBI), with or without other chemotherapeutic agents. Seven patients (10%) developed IP, 3 were due to cy...
journal_title:Transplantation
pub_type: 杂志文章
doi:10.1097/00007890-198611000-00015
更新日期:1986-11-01 00:00:00
abstract::The carbohydrate antigens, blood groups A and B, and the alpha-gal epitope (Galalpha1-3Gal) are major risk factors in transplantation. Transplantation across ABO barriers may result in rejection by elicited anti-blood group antibodies, accommodation where elicited anti-blood group antibodies do not reject the graft, o...
journal_title:Transplantation
pub_type: 杂志文章,评审
doi:10.1097/01.tp.0000142673.32394.95
更新日期:2004-10-27 00:00:00
abstract::Ranolazine is a new drug with a novel mode of action as a metabolic modulator and membrane stabilizer. In this prospective randomized double-blind trial, a porcine model of renal autotransplantation was used to assess the effects of this drug during preservation and reperfusion of kidneys cold-stored for 24 hr in phos...
journal_title:Transplantation
pub_type: 杂志文章
doi:10.1097/00007890-199011000-00004
更新日期:1990-11-01 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::Tolerance induction by CD45RB monoclonal antibody (mAb) in murine allograft models is associated with an alteration in the CD45RBlo/CD45RBhi T-cell ratio in favor of CD45RBlo T cells, which can function as regulatory cells and promote tolerance. It has been proposed that inversion of the CD45RBhi/CD45RBlo normal T-cel...
journal_title:Transplantation
pub_type: 杂志文章
doi:10.1097/01.TP.0000072373.77323.D4
更新日期:2003-07-27 00:00:00
abstract:BACKGROUND:FTY720 prevents allograft rejection with remarkable potency without inducing generalized immunosuppression. We determined the effect of FTY720 on development of autoimmune diabetes in nonobese diabetic (NOD) mice. METHODS:NOD mice were given FTY720 (0.5 mg/kg, orally) five times per week starting from 4 wee...
journal_title:Transplantation
pub_type: 杂志文章
doi:10.1097/00007890-200212270-00006
更新日期:2002-12-27 00:00:00
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
更新日期:1990-08-01 00:00:00
abstract:BACKGROUND:In a pilot trial we evaluated the toxicity and efficacy of sirolimus (rapamycin) as second-line therapy for the treatment of acute graft-versus-host disease (GVHD) in 21 patients (1-46 years of age) after allogeneic hematopoietic stem cell transplantation (HSCT). METHODS:All patients were treated with methy...
journal_title:Transplantation
pub_type: 杂志文章
doi:10.1097/00007890-200112270-00010
更新日期:2001-12-27 00:00:00
abstract:BACKGROUND:Alterations in microcirculation are considered central to the pathogenesis of hyperacute xenogeneic rejection (HXR) of vascularized xenografts, but currently there exist no data describing these microhemodynamic alterations. METHODS:Rat livers were perfused in situ with either isogeneic rat blood or xenogen...
journal_title:Transplantation
pub_type: 杂志文章
doi:10.1097/00007890-199702150-00022
更新日期:1997-02-15 00:00:00
abstract::Portal vein (PV) complications after living donor liver transplant (LDLT) have been a major concern in pediatric liver transplantation. The incidence of PV complications is more in pediatric (0%-33%) than in adult recipients. Early diagnosis and treatment of PV complications may ensure optimal graft function and good ...
journal_title:Transplantation
pub_type: 杂志文章
doi:10.1097/01.tp.0000446272.05687.ce
更新日期:2014-04-27 00:00:00
abstract::Most alloreactive T cells specifically recognize peptides bound to donor MHC molecules. In addition to peptides, solvent accessible MHC residues also may stimulate alloreactive T cells. We studied T cell receptor (TCR) usage by 16 independent anti-HLA-B7 alloreactive cytolytic T lymphocyte (CTL) clones. Most or all of...
journal_title:Transplantation
pub_type: 杂志文章
doi:10.1097/00007890-199610150-00014
更新日期:1996-10-15 00:00:00
abstract::Humoral or antibody-mediated rejection in cardiac transplant recipients is mediated by donor-specific cytotoxic antibodies and is histologically defined by linear deposits of immunoglobulin and complement in the myocardial capillaries. Antibody-mediated rejection often is accompanied by hemodynamic compromise and is a...
journal_title:Transplantation
pub_type: 杂志文章
doi:10.1097/00007890-200203270-00013
更新日期:2002-03-27 00:00:00
abstract:BACKGROUND:This study addresses the question of the mechanism for maintaining tolerance to donor alloantigen in the absence of antigen and the role of secondary lymphoid tissues. METHODS:Depleting anti-CD4 antibody administration in conjunction with allogeneic heart transplantation generates donor-specific operational...
journal_title:Transplantation
pub_type: 杂志文章
doi:10.1097/01.tp.0000259928.16003.aa
更新日期:2007-05-15 00:00:00
abstract::Patient entry is now complete in a prospective trial of anti-Tac, a murine IgG2a monoclonal antibody directed against the p55 chain of the human IL-2 receptor, for the prevention of renal allograft rejection. Recipients of primary cadaver allografts were randomized to receive either anti-Tac (20 mg q.d. x 10 days begi...
journal_title:Transplantation
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00007890-199101000-00016
更新日期:1991-01-01 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:In a pig liver transplantation model, we compared the effects of Celsior solution (CS), an extracellular preservation solution, with Viaspan (University of Wisconsin solution, UW) on graft function and animal survival. METHODS:Pig livers were flushed with either CS or UW solution and cold-stored for 12 hr (...
journal_title:Transplantation
pub_type: 杂志文章
doi:10.1097/00007890-200106270-00005
更新日期:2001-06-27 00:00:00
abstract:BACKGROUND:Long-term results of prospective randomized trials comparing triple immunosuppressive strategies combining tacrolimus (TAC) or cyclosporine A (CsA) with mycophenolate mofetil (MMF) and steroids after heart transplantation (HTX) are rarely published. Therefore, we collected long-term follow-up data of an inte...
journal_title:Transplantation
pub_type: 杂志文章,随机对照试验
doi:10.1097/TP.0b013e318277e378
更新日期:2013-02-27 00:00:00
abstract:BACKGROUND:Transplantation enhances the risk of malignancies, due to the chronic use of antirejection medication. In the case of Kaposi's sarcoma (KS) the permissive effect of immunosuppression has been extensively studied, and cyclosporine (CsA) appears to play a key role. Here we have compared the incidence of KS in ...
journal_title:Transplantation
pub_type: 杂志文章
doi:10.1097/01.tp.0000173803.97398.31
更新日期:2005-09-27 00:00:00
abstract::In a canine model of dog leukocyte antigen (DLA)-identical nonmyeloablative marrow transplantation including postgrafting immunosuppression with cyclosporine (CSP) and mycophenolate mofetil (MMF), engraftment was only transient with 100 cGy total body irradiation (TBI) conditioning, indicating suboptimal pretransplant...
journal_title:Transplantation
pub_type: 杂志文章
doi:10.1097/01.tp.0000181168.42461.0b
更新日期:2005-11-27 00:00:00
abstract:BACKGROUND:More than 60% children with small bowel transplantation (SBTx) experience acute cellular rejection. PURPOSE/METHODS:To identify children at risk of rejection, donor- and third-party-induced proliferation of T-helper and T cytotoxic (Tc) cells, and their naïve and memory (M) subsets was evaluated simultaneou...
journal_title:Transplantation
pub_type: 杂志文章
doi:10.1097/TP.0b013e3181d98c0f
更新日期:2010-06-15 00:00:00
abstract::Increased QT dispersion (QTd), predicting patients with risk of malignant arrhythmia, have recently been reported in hemodialysis patients (HDp). In this prospective study, we aimed to investigate changes in QTd and signal averaged-ECG (SAECG) in HDp after transplantation. Twenty-seven HDp (M/F:18/9, mean age 30+/-8 y...
journal_title:Transplantation
pub_type: 临床试验,杂志文章
doi:10.1097/00007890-200111150-00009
更新日期:2001-11-15 00:00:00
abstract::Orthotopic liver transplantation is frequently associated with a complex coagulation disorder, influencing the outcome of the procedure. In this respect, disseminated intravascular coagulation (DIC) had been suggested to be of causative importance for bleeding complications after reperfusion of the liver graft. In 10 ...
journal_title:Transplantation
pub_type: 杂志文章
doi:10.1097/00007890-199109000-00018
更新日期:1991-09-01 00:00:00