Abstract:
:Kidney transplant wait-list management is becoming increasingly complex. We introduced a novel wait-list management strategy at our center, the Transplant Readiness Assessment Clinic (TRAC), whereby patients whose Kidney Allocation Scores surpass a threshold are actively managed. From January 1, 2016 through June 30, 2017, we evaluated 195 patients through TRAC. Compared to pre-TRAC systems at our institution, TRAC resulted in a higher proportion of activation at 18 months (38% vs 22%-26%, P < 0.0001), despite being enriched in patients with long dialysis duration. TRAC also resulted in a higher proportion of wait-list removal (15% vs 8%-9%, P < 0.05) although combined wait-list removal and death on wait-list did not differ (18% vs 16%-17%). Median time to activation was 356 days from TRAC evaluation. Of the transplant barriers, need for cardiovascular studies was the most common (31%), followed by other medical issues (23%), poor functional status (13%), and psychosocial issues (10%). By concentrating center resources on patients most likely to be transplanted after activation and performing active patient management close to the time of transplant, TRAC has the potential to significantly enhance kidney transplant success in regions with long wait-times.
journal_name
Clin Transplantjournal_title
Clinical transplantationauthors
Cheng XS,Busque S,Lee J,Discipulo K,Hartley C,Tulu Z,Scandling JD,Tan JCdoi
10.1111/ctr.13406subject
Has Abstractpub_date
2018-11-01 00:00:00pages
e13406issue
11eissn
0902-0063issn
1399-0012journal_volume
32pub_type
杂志文章abstract:BACKGROUND:Liver transplantation with livers grafts from elderly donors has been associated with a higher risk of biliary complications. The aim of this study was to examine whether our national protocol could contribute to a lower incidence of biliary complications. METHODS:All adult recipients in the Netherlands tra...
journal_title:Clinical transplantation
pub_type: 杂志文章,多中心研究
doi:10.1111/ctr.12569
更新日期:2015-07-01 00:00:00
abstract::Retrograde arterial flush (RGAF) of liver grafts, which prevents arterial intima injuries in living donor liver transplantation (LDLT), seemed to reduce post-transplantational cholestasis by our preliminary study. The aim of this study was to further confirm this effect of RGAF of grafts in LDLT by a prospective rando...
journal_title:Clinical transplantation
pub_type: 杂志文章,随机对照试验
doi:10.1111/j.1399-0012.2011.01493.x
更新日期:2012-03-01 00:00:00
abstract::Porto-pulmonary hypertension with moderate or severe pulmonary arterial hypertension (PAH) is viewed as a contraindication to liver transplantation (LT) because of associated poor outcomes; however, patients with biliary atresia (BA) are generally good candidates for LT. Ten patients with moderate/severe PAH underwent...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/ctr.12415
更新日期:2014-09-01 00:00:00
abstract::Anti-Xa monitoring for low molecular weight heparin (LMWH) is currently recommended in obese, renally impaired, and pregnant patients. Substantial evidence indicates that solid organ transplant (SOT) patients are at an increased risk of renal impairment, thus representing a population at risk of LMWH accumulation. The...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/ctr.12240
更新日期:2013-11-01 00:00:00
abstract:BACKGROUND:The pediatric end stage liver disease (PELD) score has been used widely to prioritize children awaiting cadaveric liver transplantation (LTx). To establish the objective parameter for optimal timing of living-related LTx (LRLTx), we have assessed our cases using the PELD score. METHODS:From 1997 to 2002, 24...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/j.1399-0012.2004.00194.x
更新日期:2004-10-01 00:00:00
abstract::Patients with severe liver disease and accompanying malnutrition may exhibit electrolyte disturbances including the magnesium balance. In 18 patients plasma magnesium (p-Mg) was determined at the start of the liver transplantation and during the anhepatic and reperfusion phases of the operation. The blood loss was 6.9...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:
更新日期:1996-04-01 00:00:00
abstract::Calcineurin inhibitors (CNI) have been commonly used as pivotal immunosuppressive agents to renal transplant recipients and have contributed significantly to improving short-term allograft survival. However, long-term administration of CNI may cause an adverse effect on kidney function, known as chronic nephrotoxicity...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/j.1399-0012.2011.01474.x
更新日期:2011-07-01 00:00:00
abstract::Unresponsive pulmonary hypertension (PH) implies poor posttransplant outcomes. Data on late adaptation of the right ventricle (RV) are still few. This study evaluated three-yr RV function and remodeling, exercise capacity, and hemodynamic data in a selected group of patients initially disqualified because of PH. Betwe...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/ctr.12387
更新日期:2014-07-01 00:00:00
abstract::The non-relapse mortality of autologous stem cell transplant is low enough that the procedure has been extended to older patients with non-Hodgkin's lymphoma. We treated 537 non-Hodgkin's lymphoma patients with high-dose chemotherapy consisting of busulfan, cyclophosphamide, and etoposide followed by autologous stem c...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/j.1399-0012.2006.00581.x
更新日期:2006-11-01 00:00:00
abstract::Liver transplant (LT) outcomes are reported to be improving in non-HCV recipients but not for those infected with HCV. Our aim was to evaluate graft survival and predictors of outcome in HCV and non-HCV patients before and after 2003. Patients with primary LT between February 1, 1998, and December 31, 2005, were inclu...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/j.1399-0012.2011.01428.x
更新日期:2011-05-01 00:00:00
abstract:BACKGROUND:The benefits of pancreas transplantation are often difficult to measure. Here, we sought to determine the difference in quality of life for diabetic patients with and without a functional pancreas transplant alone (PTA). METHODS:Pancreas transplant alone cases from 1993 to 2015 were considered. An IRB-appro...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/ctr.13177
更新日期:2018-02-01 00:00:00
abstract::The effect of storage temperature on early graft function following liver transplantation was investigated by analyzing the results following transplantation during three periods in which different techniques for graft storage were used. The techniques involved ice-packing (period 1), storage in a standard operating ...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:
更新日期:1992-04-01 00:00:00
abstract::Coronary angiography (CA) is the gold standard evaluation of coronary artery disease in potential multi-organ donors. This use of iodinated contrast media could lead to contrast-induced acute kidney injury and consequently to delayed graft function (DGF). All patients in France who received a kidney from a 45-70-year-...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/ctr.13355
更新日期:2018-09-01 00:00:00
abstract::Sauropus androgymus (SA), a vegetable of the Euphorbiaceae family, is a common food source in Malaysia. In Taiwan, over 30 patients have developed progressive respiratory failure after consuming the extract from raw SA leaves as a means of losing weight. Symptoms consistent with a severe obstructive ventilatory defect...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1034/j.1399-0012.1999.130610.x
更新日期:1999-12-01 00:00:00
abstract::Living-related liver transplantation (LRLT) in pediatric recipients has been successful with 90% 1-year survival (1, 2). LRLT in adults is yet to succeed. We hypothesize a management strategy based on the donor graft weight-to-recipient body weight ratio (GRBWR) and the Redox Tolerance Index (RTI) (3). Favorable recip...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:
更新日期:1995-02-01 00:00:00
abstract:BACKGROUND:Renal transplant outcomes in Hispanics have been conflicting regarding acute rejection (AR) and allograft survival. Additionally, the feasibility of early corticosteroid withdrawal (ECW) regimens among Hispanics has not been adequately addressed. The purpose of this study is to report outcomes following ECW ...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/ctr.12218
更新日期:2013-11-01 00:00:00
abstract:BACKGROUND:More data are needed regarding the incidence, risk factors, and outcomes for Clostridioides difficile infection (CDI) and colonization in patients undergoing an autologous hematopoietic stem cell transplantation (AHSCT). METHODS:We studied 472 consecutive patients admitted for a first AHSCT and conducted a ...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/ctr.13712
更新日期:2019-11-01 00:00:00
abstract::Although risk factors for failure of renal retransplants have been well studied, the impact of allograft nephrectomy on subsequent renal transplantation in the cyclosporin era is not well defined. The purpose of this study is to define the effect of nephrectomy of the primary allograft on subsequent allograft survival...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:
更新日期:1996-04-01 00:00:00
abstract::Patients with failing Fontan physiology and liver cirrhosis are being considered for combined heart and liver transplantation. We performed a retrospective review of our experience with en bloc combined heart and liver transplantation in Fontan patients > 10 years old from 2006 to 18 per Institutional Review Board app...
journal_title:Clinical transplantation
pub_type: 临床试验,杂志文章
doi:10.1111/ctr.13540
更新日期:2019-06-01 00:00:00
abstract::Islet yield is an important predictor of acceptable glucose control after total pancreatectomy with islet autotransplantation (TP-IAT). We assessed if pancreas volume calculated with preoperative MRI could assess islet yield and postoperative outcomes. We reviewed dynamic MRI studies from 154 adult TP-IAT patients (20...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/ctr.14008
更新日期:2020-08-01 00:00:00
abstract::Post-transplant erythrocytosis (PTE) has been increasingly recognized as a complication of kidney transplantation, and several risk factors have been defined. Recent evidence suggests renal function may also play a role in hematological recovery after transplantation and risk of PTE. In this study of kidney transplant...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:
更新日期:1995-10-01 00:00:00
abstract::Kidney transplantation offers longer survival, less morbidity and lower costs than dialysis. It is also believed to improve quality of life. The aim of this study was to compare prospectively the perceived health status (PHS) of dialyzed patients on a waiting list with kidney transplant recipients after transplantatio...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/j.1399-0012.2009.01080.x
更新日期:2010-05-01 00:00:00
abstract:UNLABELLED: BACKGROUND:Rabbit anti-thymocyte globulin (rATG) induction reduces reperfusion injury and improves renal function in kidney recipients by means of properties unrelated to T-cell lysis. Here, we analyze intensive rATG induction (single dose, rATG(S) , vs. divided dose, rATG(D) ) for improved renal function ...
journal_title:Clinical transplantation
pub_type: 杂志文章,随机对照试验
doi:10.1111/j.1399-0012.2011.01425.x
更新日期:2012-01-01 00:00:00
abstract:INTRODUCTION:There is a severe shortage of organs for transplantation worldwide, and Mexico has one of the lowest organ donation rates. In this study, we explored the psychosocial barriers that prevent posthumous organ donation by Mexicans. METHOD:We asked 218 adults who were not willing to be donors to complete the s...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/ctr.13112
更新日期:2017-11-01 00:00:00
abstract::With increasing shortage of donor organs and changes in organ allocation systems, there is a considerable need for alternative or supportive techniques in the field of liver transplantation. Liver cell transplantation (LCT) is such an innovative technique that is especially promising for use in children, because it is...
journal_title:Clinical transplantation
pub_type: 杂志文章,评审
doi:10.1111/j.1399-0012.2009.01113.x
更新日期:2009-12-01 00:00:00
abstract::Inflammatory and metabolic response is an important factor to determine clinical outcomes. However, it remains unknown in children undergoing heart transplantation (HTx). We examined the perioperative changes in the inflammatory and metabolic response markers C-reactive protein (CRP) and prealbumin (PA) in 38 heart-tr...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/j.1399-0012.2011.01566.x
更新日期:2012-03-01 00:00:00
abstract:BACKGROUND/AIMS:There remains a critical shortage of cadaveric organs. At a large inner city level one trauma centre, several strategies were devised and combined to (a). optimize the physiologic status of potential donors, (b). promote awareness of the donation process among health care professionals and (c). perform ...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1034/j.1399-0012.17.s9.10.x
更新日期:2003-01-01 00:00:00
abstract::There is paucity in the data examining the differences in mycophenolate mofetil (MMF) dosing and outcomes among pediatric kidney transplant recipients (PKTX) between races. The aims of this study were as follows (i) to assess whether higher doses of MMF are being utilized in African American (AA) PKTX (ii) to determin...
journal_title:Clinical transplantation
pub_type: 临床试验,杂志文章
doi:10.1111/j.1399-0012.2010.01304.x
更新日期:2011-07-01 00:00:00
abstract::Therapeutic living donor nephrectomy is defined as a nephrectomy that is performed as therapy for an underlying medical condition. The patient directly benefits from having their kidney removed, but the kidney is deemed transplantable. The kidney is subsequently used as an allograft for an individual with advanced ren...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/ctr.13715
更新日期:2019-12-01 00:00:00
abstract:BACKGROUND:Multidrug-resistant (MDR) gram-negative bacteria are a growing threat to solid organ transplantation (SOT) patients in the intensive care unit (ICU). We aimed to examine the mortality rates of gram-negative MDR bacterial infection in SOT patients compared with patient population undergoing other cardiothorac...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/ctr.12575
更新日期:2015-09-01 00:00:00