Abstract:
:Obese transplant recipients (BMI ≥ 30 kg/m2 ) have decreased posttransplant patient and graft survival compared with their nonobese counterparts. At the same time, many prednisone-related side effects (eg, new-onset diabetes) are similar to those associated with obesity. Using SRTR data, we studied outcomes associated with prednisone-free maintenance immunosuppression (rapid discontinuation of prednisone-RDP). Between January 1, 2000, and December 31, 2014, 44 635 first transplant recipients with BMI ≥ 30 kg/m2 had a first kidney transplant (28 176 DD; 16 459, LD); 12,994 (29%) were discharged from the hospital on a prednisone-free protocol. We compared outcomes to those discharged on a protocol incorporating maintenance prednisone (intention-to-treat analysis). RDP-treated obese first DD recipients had significantly better patient survival (HR, 0.88; CI, 0.81-0.96) and graft survival (HR, 0.93; CI, 0.88-0.99) compared with their counterparts on maintenance immunosuppression. Although not statistically significant, the same trends were seen for LD recipients. For both DD and LD recipients, there was no difference between groups for death-censored graft survival, suggesting that the benefit of RDP was due to improved patient survival. Our findings suggest that kidney transplant recipients with BMI ≥ 30 kg/m2 benefit from a protocol that incorporates RDP.
journal_name
Clin Transplantjournal_title
Clinical transplantationauthors
Matas AJ,Vock DMdoi
10.1111/ctr.13668subject
Has Abstractpub_date
2019-10-01 00:00:00pages
e13668issue
10eissn
0902-0063issn
1399-0012journal_volume
33pub_type
杂志文章abstract::In this single-institution study, we compared outcomes in diabetic recipients of living donor (LD) kidney transplants that did vs. did not undergo a subsequent pancreas transplant. Of 307 diabetic recipients who underwent LD kidney transplants from January 1, 1995, through December 31, 2003, a total of 175 underwent a...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/j.1399-0012.2009.00998.x
更新日期:2009-08-01 00:00:00
abstract::Hepatitis C virus (HCV) is currently the leading indication worldwide for orthotopic liver transplantation. However, the majority of patients receiving transplant for HCV eventually develop histopathologic evidence of recurrent allograft HCV and approximately 10% die or require retransplantation within the first 5 pos...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1034/j.1399-0012.2003.00049.x
更新日期:2003-06-01 00:00:00
abstract:INTRODUCTION:Aortoiliac pathology in kidney allograft recipients is not rare but treatment timing is controversial. As most publications on this topic are case reports its difficult to evaluate long-term outcomes of those clinical challenges. Herein we report long-term results of these procedures. METHODS:From 1970 to...
journal_title:Clinical transplantation
pub_type: 临床试验,杂志文章
doi:10.1111/j.1399-0012.2009.00981.x
更新日期:2009-03-01 00:00:00
abstract:BACKGROUND:A questionnaire study was designed to determine whether the quality of life benefit provided by receiving a kidney-pancreas (KP) transplant increased the incentive to return to work, compared with patients receiving a kidney alone (KA) transplant. METHODS:A confidential questionnaire was sent to 58 patients...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/j.1399-0012.2004.00115.x
更新日期:2004-02-01 00:00:00
abstract::The progression of HCV-related disease is particularly aggressive in the post-transplantation setting. Recipients with recurrent HCV infection undergo repeated liver biopsies in order to estimate disease progression. A strong association was found between serum immunoglobulins levels and hepatic fibrosis in non-transp...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/j.1399-0012.2007.00657.x
更新日期:2007-05-01 00:00:00
abstract::Clinical small bowel transplantation (SBTx) has been associated with a high rate of infectious complications. Laparotomy, preservation injury, abnormal motility, lymphatic disruption, aberrant systemic venous drainage, rejection and antibiotic therapy could all be implicated in the etiology of these complications. In ...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1034/j.1399-0012.2000.140609.x
更新日期:2000-12-01 00:00:00
abstract::In view of the scarcity of organ resources available for transplantation, living donor liver transplantation (LDLT) is gaining growing importance in the treatment of chronically terminal liver diseases. In the period between December 1999 and October 2000, 47 potential living liver donors were evaluated and 24 right h...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1034/j.1399-0012.2002.02002.x
更新日期:2002-10-01 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::Atherosclerosis is a chronic inflammatory process affecting mainly elastic and muscular arteries. Although small arteries and arterioles are usually spared, atherosclerosis can occur in these small vasculatures for a very short period. Here we report a case of atherosclerosis-like lesions that occurred in a transplant...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1034/j.1399-0012.16.s8.7.x
更新日期:2002-01-01 00:00:00
abstract:BACKGROUND:The goal of immunosuppressive therapy in heart transplantation is to maximize safety and efficacy while minimizing morbidity and mortality. We now have numerous drug combinations, but few have been compared with each other. AIM:To compare various immunosuppressive regimens assessing morbidity and mortality ...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/j.1399-0012.2007.00751.x
更新日期:2008-01-01 00:00:00
abstract::We herein report the first case of immunosuppression-associated thrombotic microangiopathy (TMA) in which an extrarenal graft was primarily affected by the characteristic microvascular lesions. Although TMA is a well-known complication of cyclosporine (CSA) or tacrolimus therapy in renal and extrarenal (liver, heart, ...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:
更新日期:1998-12-01 00:00:00
abstract::In live related renal transplant program, management of multiple renal arteries (MRA) is technically demanding and used to be considered a relative contraindication because of increased risk of vascular and urologic complications. We present a retrospective analysis of the outcome of grafts with MRA and suggest certai...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1034/j.1399-0012.2001.150209.x
更新日期:2001-04-01 00:00:00
abstract:BACKGROUND:Prior liver transplantation and immunosuppression potentially translate into significant morbidity and poor outcomes after any type of pancreatic surgery. Little is known about the outcomes of pancreatic surgery after liver transplantation. This study was designed to review our experience regarding the indic...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/ctr.12317
更新日期:2014-03-01 00:00:00
abstract:BACKGROUND:The aim of this study was to see whether lessons could be learned from the prospectively maintained nationwide database on solitary pancreas transplantation (SPTx) performed in the UK. METHODS:Two hundred and forty-five SPTx were utilized from the 2004-2013 period (113 pancreas transplant alone and 132 panc...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/ctr.12650
更新日期:2015-12-01 00:00:00
abstract::Cytomegalovirus (CMV) infection complicates the post-operative course of patients receiving solid organ transplants. While ganciclovir has significantly reduced the direct effects of CMV infection, some patients cannot tolerate the optimal therapeutic exposure required for CMV prevention and treatment. Few reports dir...
journal_title:Clinical transplantation
pub_type: 杂志文章,评审
doi:10.1111/j.1399-0012.2008.00942.x
更新日期:2009-06-01 00:00:00
abstract::The combination of methotrexate and cyclosporine A (MTX-CSA) is the standard regimen for the prevention of graft vs. host disease (GVHD) after allogeneic hematopoietic stem cell transplantation (allo-SCT) from HLA-identical siblings. Mycophenolate mofetil and CSA (MMF-CSA) combination has been successfully used for GV...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/j.1399-0012.2008.00894.x
更新日期:2009-01-01 00:00:00
abstract::The exact mechanism of acute and chronic allograft rejection still remains unclear. The chemokine SDF-1 as mediator of allograft rejection has been under intensive investigation in liver, cardiac and bone marrow transplantation, whereas in renal transplantation, there are no reports about SDF-1 to date. This study was...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/j.1399-0012.2006.00540.x
更新日期:2006-11-01 00:00:00
abstract::The shortage of kidney donors has led to broadening of the acceptance criteria for deceased donor organs beyond the traditional use of young donors. We determined long-term post-transplant outcomes in recipients of dual expanded criteria donor kidneys (dECD, n = 44) and compared them to recipients of standard criteria...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/j.1399-0012.2009.00956.x
更新日期:2009-06-01 00:00:00
abstract::Angiotensin-converting enzyme inhibitor (ACEI) has become recognized as agents that have renoprotective effects in the treatment of progressive renal diseases including post-transplant kidneys. Previously we demonstrated the safety and effectiveness of ACEI treatment on the hypertensive proteinuric post-transplant pat...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/j.1399-0012.2004.00244.x
更新日期:2004-01-01 00:00:00
abstract::The current pandemic SARS-CoV-2 has required an unusual allocation of resources that can negatively impact chronically ill patients and high-complexity procedures. Across the European Reference Network on Pediatric Transplantation (ERN TransplantChild), we conducted a survey to investigate the impact of the COVID-19 o...
journal_title:Clinical transplantation
pub_type: 杂志文章,多中心研究
doi:10.1111/ctr.14063
更新日期:2020-10-01 00:00:00
abstract:BACKGROUND:Our purpose was to determine the complication rate from intravascular ultrasound (IVUS) in a large, multicenter cohort of pediatric heart transplant (PHT) patients. METHODS:We retrospectively reviewed all PHT who underwent IVUS at 5 institutions (2006-2014). Rates of major and minor complications were calcu...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/ctr.13981
更新日期:2020-09-01 00:00:00
abstract:BACKGROUND:Post-transplant gastrointestinal (GI) side effects can impair a patient's quality of life (QoL). This study investigates the improvement in GI side effects and related QoL changes in recipients of liver transplantation (OLT) after converting patients from mycophenolate mofetil (MMF) to enteric-coated mycophe...
journal_title:Clinical transplantation
pub_type: 临床试验,杂志文章
doi:10.1111/j.1399-0012.2009.01019.x
更新日期:2009-11-01 00:00:00
abstract::Lung transplantation remains the only curative treatment option for selected patients with end-stage interstitial lung disease (ILD). Candidate selection is impeded by patient heterogeneity, particularly in the subgroup of non-idiopathic pulmonary fibrosis (non-IPF) interstitial lung diseases. We performed a descripti...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/ctr.13661
更新日期:2019-10-01 00:00:00
abstract:BACKGROUND:Patients on organ transplant waiting lists continue to far exceed donor rates. We seek to understand the barriers preventing people in a Canadian city from donating organs for transplantation. METHODS:One thousand adults were surveyed assessing knowledge, personal involvement, and attitudes about organ dona...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/j.1399-0012.2010.01260.x
更新日期:2010-11-01 00:00:00
abstract:OBJECTIVE:The aim of this study was to investigate the hypothesis that intraoperative infusion of dexmedetomidine can exert a protective effect against hepatic ischemia-reperfusion injury (IRI) in adult living donor liver transplantation (LDLiver transplantation). PATIENTS AND METHODS:Forty recipients were allocated i...
journal_title:Clinical transplantation
pub_type: 杂志文章,随机对照试验
doi:10.1111/ctr.12713
更新日期:2016-04-01 00:00:00
abstract::Delayed graft function (DGF) remains a major barrier to improved outcomes after kidney transplantation. High-risk transplant recipients can be identified, but no definitive prediction model exists. Novel biomarkers to predict DGF in the first hours post-transplant, such as neutrophil gelatinase-associated lipocalin (N...
journal_title:Clinical transplantation
pub_type: 杂志文章,评审
doi:10.1111/ctr.12832
更新日期:2016-10-01 00:00:00
abstract::Proven Pneumocystis carinii pneumonia (PCP) occurred in 8 (5.2%) of 154 adult liver transplant recipients between January 1986 and December 1992. The interval between transplantation and PCP ranged from 69 to 131 days with a mean of 95 days (SD 20 days). The PaO2 breathing room air at diagnosis ranged from 40 mmHg to ...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:
更新日期:1994-12-01 00:00:00
abstract::The concept of a narrow therapeutic window has guided the management of transplant recipients on cyclosporine immunosuppression since its inception more than a decade ago. The need to maintain immunosuppression and avoid toxicity imposed the requirement of monitoring cyclosporine levels within a limited range. The use...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:
更新日期:1995-04-01 00:00:00
abstract::During liver transplant (LT), the release of vasoactive substances into the systemic circulation is associated with severe hemodynamic instability that is injurious to the recipient and/or the post-ischemic graft. Crystalloid flush with backward unclamping (CB) and portal blood flush with forward unclamping (PF) are t...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/ctr.12130
更新日期:2013-07-01 00:00:00
abstract:OBJECTIVES:To analyze the characteristics of tuberculosis (TB) in Southern Chinese renal transplant recipients, and summarize the corresponding experiences in diagnosis and management. METHOD:Retrospectively study 41 documented post-transplant TB cases out of the 2333 patients who received kidney transplantation in th...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/j.1399-0012.2008.00878.x
更新日期:2008-11-01 00:00:00