Abstract:
:Survival despite prolonged non-adherence with immunosuppression is rare but has been reported in kidney, lung, and liver transplantation. Its occurrence in heart transplantation is quite rare. Our study was prompted by an index patient who survived despite prolonged medication non-adherence. Prospective consent and blood collection were conducted for seven additional patients who presented in a similar fashion. The blood of patients who were diagnosed with rejection, stable early post-transplant, and stable more than 5 years post-transplant were all compared with a custom gene array focusing on T-regulatory cell processes. The two genes that were differentially expressed in every comparison were TGF beta and RNASEN with very low expression in the rejector group. The prolonged non-adherent group had the maximum expression for TGF beta but average RNASEN expression as compared to the low expression for rejectors and high for post-5 years patients. The patients presented survived for varying lengths of time without immunosuppression. The gene array analysis showed intriguing differences between these rare patients and important patient cohorts. Further efforts should be directed to finding and studying more patients who survive despite lack of prescribed immunosuppression. The mechanisms underlying this phenomenon may inform future advances in transplant immunosuppression.
journal_name
Clin Transplantjournal_title
Clinical transplantationauthors
Baran DA,Rao P,Deo D,Zucker MJdoi
10.1111/ctr.13834subject
Has Abstractpub_date
2020-05-01 00:00:00pages
e13834issue
5eissn
0902-0063issn
1399-0012journal_volume
34pub_type
杂志文章abstract::Lymphocyte cultures grown from liver allograft biopsies were shown to exhibit alloreactivity towards donor cells as measured by primed lymphocyte testing (PLT). The PLT specificity was determined in assays using HLA typed panel cells and/or by inhibition testing with HLA specific monoclonal antibodies. Certain culture...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:
更新日期:1988-01-01 00:00:00
abstract:BACKGROUND:Cardiac allograft vasculopathy (CAV) limits survival after heart transplantation (HTx). Between immunologic and non-immunologic factors, reactive oxygen species generation has been proposed as pathogenetic mechanism. This study was aimed at evaluating redox status in HTx recipients and verifying whether it c...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/j.1399-0012.2005.00352.x
更新日期:2005-06-01 00:00:00
abstract:INTRODUCTION:Atherosclerosis is a serious complication and leading cause of mortality in renal transplant recipients (RTRs). Hyperlipidemia may be associated with progression of renal disease and chronic allograft dysfunction. Similarities in the pathogenesis of glomerulosclerosis and atherosclerosis have been proposed...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/j.1399-0012.2004.00162.x
更新日期:2004-06-01 00:00:00
abstract::Coronary artery disease (CAD) is a pathology often found in patients with end-stage lung disease. Although in the past CAD might have been considered an absolute contraindication, modern revascularization techniques have helped increase the number of transplants performed in this population. However, discrepancies in ...
journal_title:Clinical transplantation
pub_type: 杂志文章,评审
doi:10.1111/ctr.14078
更新日期:2020-11-01 00:00:00
abstract::In Norway living kidney donors account for approximately 40% of all renal transplants. There is a shortage of information about how living kidney donors experience the donation process during the initial recovery from surgery. The aim of this study was to explore physical and psychosocial issues related to the experie...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/j.1399-0012.2004.00304.x
更新日期:2005-02-01 00:00:00
abstract:INTRODUCTION:Conversion from calcineurin inhibitor (CI)-based maintenance immunosuppression to sirolimus (SRL)-based immunosuppression may be beneficial in selected renal transplant recipients. The purpose of this study was to evaluate the safety and efficacy of a daclizumab (DAC) bridge protocol in patients converted ...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/j.1399-0012.2004.00220.x
更新日期:2004-01-01 00:00:00
abstract::Sarcopenia frequently occurs in cirrhotic patients who are waiting for liver transplantation (LT). This disease is associated with increased morbidity and mortality rates during the LT period. Recently, the careful assessment of nutritional status for end-stage liver disease patients has received a great deal of atten...
journal_title:Clinical transplantation
pub_type: 杂志文章,评审
doi:10.1111/ctr.13741
更新日期:2019-12-01 00:00:00
abstract::As experience with tacrolimus (FK506, Prograf) accumulates and reduced rejection rates are increasingly demonstrated, some transplant centers are adopting tacrolimus-based primary immunosuppressive regimens for their patients undergoing pancreas/kidney transplantation. The guidelines provided in this article based on ...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:
更新日期:1998-06-01 00:00:00
abstract:BACKGROUND:Clearance of hepatitis C virus (HCV) under antiviral therapy, including direct-acting antivirals (DAAs), has been associated with higher risk of rejection. Whether patients who are not on immunosuppression (IS) during DAA therapy are at higher risk of rejection is unknown. METHODS:Four transplant recipients...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/ctr.13303
更新日期:2018-07-01 00:00:00
abstract::As fertility can be restored to normal soon after a kidney transplant, it is important for physicians caring for recipients to be able to inform the patient about the potential risks of pregnancy. Current opinion is that pregnancy can be successful if carried out under optimal circumstances, including stable allograft...
journal_title:Clinical transplantation
pub_type: 杂志文章,评审
doi:10.1111/j.1399-0012.2011.01492.x
更新日期:2011-11-01 00:00:00
abstract::Acute renal failure (ARF) is a common and severe complication after liver transplantation (LT). The aim of this study was to ascertain the impact of ARF requiring dialysis in the outcome of LT and to analyze the risk factors leading to this event in the early post-operative period. From October 1988 to December 1994, ...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:
更新日期:1998-04-01 00:00:00
abstract::In a cohort of 32 renal transplant patients who are potentially at risk for adverse events, we compared tacrolimus (TAC) abbreviated AUC values calculated by a method developed in Asians (AUCw) with those derived for Caucasians (AUCa). The relationships between TAC trough (C0), abbreviated AUC, and biopsy results were...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/j.1399-0012.2009.01143.x
更新日期:2010-07-01 00:00:00
abstract::Although FK 506 has been shown to effectively reverse refractory renal allograft rejection, its ability to reverse accelerated renal allograft rejection as a primary agent has not been specifically addressed. Herein evidence of the ability of FK 506 to reverse accelerated renal allograft rejection is presented. A 16-y...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:
更新日期:1997-08-01 00:00:00
abstract::The objective of this meta-analysis was to review the evidence for the use of immune globulin in the prevention of symptomatic cytomegalovirus (CMV) disease in transplant recipients. A computerized search of Medline from 1980 to October 1991 was conducted using the textword "cytomegalo:" and the subheading "prevention...
journal_title:Clinical transplantation
pub_type: 杂志文章,meta分析
doi:
更新日期:1994-02-01 00:00:00
abstract::This multicenter, randomized trial aimed to compare the safety and efficacy of an early reduction in corticosteroid dose vs. long-term maintenance in Brazilian patients on an immunosuppressive regimen based on tacrolimus and mycophenolate mofetil (MMF). In the control arm, prednisone was progressively reduced from day...
journal_title:Clinical transplantation
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1111/j.1399-0012.2009.01185.x
更新日期:2010-07-01 00:00:00
abstract::Simultaneous pancreas-kidney transplantation is an established procedure for patients with type I diabetes and end-stage renal disease. Continuous advances in the operation techniques with consequent reduction of perioperative morbidity and mortality and the introduction of modern immunosuppressive agents improved not...
journal_title:Clinical transplantation
pub_type: 杂志文章,评审
doi:10.1111/j.1399-0012.2006.00599.x
更新日期:2006-01-01 00:00:00
abstract:OBJECTIVE:Urinary tract infections (UTIs) account for significant morbidity after kidney transplantation (KT). Screening for asymptomatic bacteruria (AB) has proven to be beneficial in certain population including pregnant women; however, it is not well-studied in KT population. We reviewed the incidence, clinical feat...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/ctr.12954
更新日期:2017-05-01 00:00:00
abstract::Subclinical rejection (SCR) is quite common early following renal transplantation and decreases progressively with time. The immunological profile of the recipient, the immunosuppressive regimen used, and the occurrence of prior episodes of clinical acute rejection (AR) are all risk factors for SCR. SCR, in turn, is a...
journal_title:Clinical transplantation
pub_type: 杂志文章,评审
doi:10.1111/j.1399-0012.2008.00888.x
更新日期:2009-03-01 00:00:00
abstract::The potential influence of racially or ethnically diverse cultural perspectives on patient compliance with post-transplant treatments is discussed. Domains of competency regarding culturally sensitive clinical practice are outlined to assist providers in better understanding the perspectives that may influence the vie...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:
更新日期:1997-12-01 00:00:00
abstract:BACKGROUND:The survival of patients returning to hemodialysis (HD) following kidney transplant failure is unfavorable. However, the factors responsible for this poor outcome are largely unknown; chronic inflammation due to failed allograft and malnutrition may contribute to morbidity and mortality. We aimed to compare ...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/j.1399-0012.2009.01097.x
更新日期:2010-07-01 00:00:00
abstract::In a retrospective analysis of stable cadaveric renal transplant patients we identified 19 patients with high (> 270 mg/dl) and 12 patients with low (< 170 mg/dl) serum cholesterol levels. We found that patients with high cholesterol level had higher serum cyclosporine levels despite similar oral dose of cyclosporine,...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:
更新日期:1994-08-01 00:00:00
abstract::Organ donor availability is the major limiting factor in pediatric liver transplantation, and many children succumb from their liver disease before a suitable donor can be found. In an attempt to overcome this shortage, reduced-size liver transplantation, split liver transplantation, and living-donor liver transplanta...
journal_title:Clinical transplantation
pub_type: 杂志文章,评审
doi:
更新日期:1991-04-01 00:00:00
abstract:BACKGROUND:There are little data on the pre- and post-liver transplantation (LT) outcomes of patients having autoimmune hepatitis-primary biliary cholangitis (AIH-PBC), AIH-primary sclerosing cholangitis (AIH-PSC), and AIH-small-duct PSC (AIH-SDPSC). The aim of this study was to analyze pre- and post-LT outcomes and su...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/ctr.13841
更新日期:2020-05-01 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::Although many report intra-operative cardiac arrests (ICAs) in liver transplantation (LT), the incidence, major causes, and outcome remain unclear. We aimed to investigate retrospectively, the incidence, nature, and outcome of ICA in Asian population and to identify risk factors for ICA. Consecutive 1071 LTs in an ins...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/ctr.12085
更新日期:2013-03-01 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::As there are other lesions in the cardiac allografts of long-term survivors, it is best to refer to the vascular lesion as "graft vascular disease". Graft vascular disease may be evident as early as 3 months after cardiac transplantation and may cause death in the recipient as late as 22 years post-transplant. The dis...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:
更新日期:1994-06-01 00:00:00
abstract:BACKGROUND:The Southeastern Kidney Transplant Coalition was created in 2010 to improve kidney transplant (KTx) rates in Georgia, North Carolina, and South Carolina. To identify dialysis staff-reported barriers to transplant, the Coalition developed a survey of dialysis providers in the region. METHODS:All dialysis uni...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/ctr.12693
更新日期:2016-04-01 00:00:00
abstract::Donor lung allocation in the United States focuses on decreasing waitlist mortality and improving recipient outcomes. The implementation of allocation policy to match deceased donor lungs to waitlisted patients occurs through a unique partnership between government and private organizations, namely the Organ Procureme...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/ctr.13873
更新日期:2020-07-01 00:00:00
abstract::This prospective study aimed at determining the ganciclovir exposure observed under a daily dosage of 450 mg valganciclovir routinely applied to kidney transplant recipients with a GFR above 25 mL/min at risk for cytomegalovirus (CMV) disease. Ganciclovir levels at trough (C(trough)) and at peak (C₃(h)) were measured ...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/j.1399-0012.2009.01205.x
更新日期:2010-11-01 00:00:00