Abstract:
:The high prevalence of heart failure has increased the candidate list for heart transplantation; however, there is a shortage of viable donated organs, which is responsible for the high mortality of patients awaiting a transplantation. Because the marginal donor presents additional risk factors, it is not considered to be an ideal donor. The use of a marginal donor is only justified in situations when the risk of patient death due to heart disease is greater than that offered by the donor. These recommendations sought to expand the supply of donors, consequently increasing the transplant rate. We selected articles based on robust evidence to provide a substratum to develop recommendations for donors who exceed the traditional acceptance criteria. Recipient survival in the immediate postoperative period is intimately linked to allograft quality. Primary allograft failure is responsible for 38% to 40% of immediate deaths after heart transplantation: therefore; marginal donor selection must be more rigorous to not increase the surgical risk. The main donor risk factors with the respective evidence levels are: cancer in the donor (B), female donor (B), donor death due to hemorrhagic stroke (B), donor age above 50 years (relative risk [RR] = 1.5) (B), weight mismatch between donor and recipient < 0.8 (RR = 1.3) (B), ischemia > 240 minutes (RR = 1.2) (B), left ventricular dysfunction with ejection fraction below 45% (B), and use of high doses of vasoactive drugs (dopamine > 15 mg/kg·min) (B). Factors that impact recipient mortality are: age over 50 years (RR = 1.5); allograft harvest at a distance; adult recipient weighing more than 20% of the donor; high doses of vasoactive drugs (dopamine greater than 15 mg/kg·min) and ischemic time >4 hours. The use of a marginal donor is only justified when it is able to increase life expectancy compared with clinical treatment, albeit the outcomes are interior to those using an ideal donor.
journal_name
Transplant Procjournal_title
Transplantation proceedingsauthors
Fiorelli AI,Stolf NA,Pego-Fernandes PM,Oliveira Junior JL,Santos RH,Contreras CA,Filho DD,Dinkhuysen JJ,Moreira MC,Mejia JA,Castro MCdoi
10.1016/j.transproceed.2010.12.047subject
Has Abstractpub_date
2011-01-01 00:00:00pages
211-5issue
1eissn
0041-1345issn
1873-2623pii
S0041-1345(10)01962-7journal_volume
43pub_type
杂志文章abstract:INTRODUCTION:C2 (2-hour post-absorption levels) monitoring of cyclosporine (CsA) seems to reduce the rate of acute rejection episodes (ARE) without increasing nephrotoxicity during the first months after transplant. There are a few reports on the impact of adopting this strategy in patients with stable renal transplant...
journal_title:Transplantation proceedings
pub_type: 临床试验,杂志文章
doi:10.1016/j.transproceed.2004.09.016
更新日期:2005-04-01 00:00:00
abstract:BACKGROUND:New immunosuppressives have improved the results of renal transplants. However, the features of donors and recipients have changed, producing an increased age in both cases and more donors dying from strokes. We analyzed the impact of donor and recipient profile on survival of graft in recipients treated wit...
journal_title:Transplantation proceedings
pub_type: 杂志文章,多中心研究
doi:10.1016/j.transproceed.2005.09.099
更新日期:2005-11-01 00:00:00
abstract::This retrospective review presented the prevalence and manifestations of tuberculosis among renal transplant recipients in our center between 1987 and mid 2007. The prevalence of tuberculosis was 5/151 (3.3%) recipients with a median age of 49 years (range = 38-55). The median time of diagnosis after transplantation w...
journal_title:Transplantation proceedings
pub_type: 杂志文章
doi:10.1016/j.transproceed.2008.06.020
更新日期:2008-09-01 00:00:00
abstract::The model for end-stage liver disease (MELD) has been an excellent predictor of 3-month mortality among cirrhotic patients awaiting orthotopic liver transplantation (OLT). The aim of this study was to evaluate whether the preoperative MELD score predicts short-term prognosis after OLT. We enrolled 98 adult liver trans...
journal_title:Transplantation proceedings
pub_type: 杂志文章
doi:10.1016/j.transproceed.2006.06.031
更新日期:2006-09-01 00:00:00
abstract:BACKGROUND:Clinical studies of uterus transplantation have been performed to treat uterine factor infertility. Because the uterus is a pelvic visceral organ, the method of perfusion for the procurement of vital organs from a brain-dead donor should be modified for removal of the uterus. Herein, we report the results of...
journal_title:Transplantation proceedings
pub_type: 杂志文章
doi:10.1016/j.transproceed.2015.12.105
更新日期:2016-05-01 00:00:00
abstract:OBJECTIVE:The purpose of this study was to evaluate the safety and efficacy of induction with Campath-1H with low-dose cyclosporine (CsA) monotherapy using outcome measures of acute rejection episodes (ARE), chronic allograft nephropathy (CAN), graft and patient survivals, as well as malignancies and infections. MATER...
journal_title:Transplantation proceedings
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.transproceed.2008.07.085
更新日期:2008-09-01 00:00:00
abstract:BACKGROUND:Patients undergoing urgent heart transplantation (HT) have a poorer prognosis and more long-term complications. The objective of this study was to compare the preoperative course in patients undergoing urgent HT according to the need for preoperative intra-aortic balloon counterpulsation (IABP). MATERIALS A...
journal_title:Transplantation proceedings
pub_type: 杂志文章
doi:10.1016/j.transproceed.2008.08.114
更新日期:2008-11-01 00:00:00
abstract:INTRODUCTION:Familial amyloidotic polyneuropathy (FAP) is a neurodegenerative disease that leads to sensory and motor polyneuropathies as well as functional limitations. So far, liver transplantation is the only treatment for FAP because the mutated protein causing the disease is mainly produced in the liver. With the ...
journal_title:Transplantation proceedings
pub_type: 杂志文章
doi:10.1016/j.transproceed.2010.12.025
更新日期:2011-01-01 00:00:00
abstract::In pediatric liver transplantation, both for cadaveric and living-related patients, the Roux-en-Y hepaticojejunostomy is often preferable to biliary reconstruction. Duct-to-duct biliary reconstruction in pediatric patients has been utilized only in a limited numbers of studies. Here, we retrospectively review our expe...
journal_title:Transplantation proceedings
pub_type: 杂志文章
doi:10.1016/j.transproceed.2007.02.046
更新日期:2007-05-01 00:00:00
abstract:BACKGROUND:Bronchiolitis obliterans is the most significant complication adversely affecting the survival of lung allograft recipients. Injury and loss of epithelium are associated with obliteration of the airway lumen. The aim of this study was to examine the effects of various immunosuppressants on airway epithelium....
journal_title:Transplantation proceedings
pub_type: 杂志文章
doi:10.1016/j.transproceed.2006.01.042
更新日期:2006-04-01 00:00:00
abstract::Disorders of homeostasis and an increased incidence of infection in patients undergoing hemodialysis causes frequent appearance of pathologic changes in the oral mucosa. The organ transplant and subsequent pharmacologic immunosuppression may result in systemic disorders manifesting by pathologic oral lesions. METHODS...
journal_title:Transplantation proceedings
pub_type: 杂志文章
doi:10.1016/j.transproceed.2020.02.105
更新日期:2020-10-01 00:00:00
abstract:BACKGROUND:We performed a modified right hepatectomy completely by laparoscopic techniques preserving the middle hepatic vein (MHV) branches in adult-to-adult living donor liver transplantation (LDLT). PATIENTS AND METHODS:Two young women (24 and 25 years old) volunteered to be live donors for their parents who had he...
journal_title:Transplantation proceedings
pub_type: 杂志文章
doi:10.1016/j.transproceed.2008.07.134
更新日期:2008-12-01 00:00:00
abstract:OBJECTIVES:To compare patient graft survival between various subgroups among renal transplant patients. PATIENTS AND METHODS:A retrospective analysis of all renal transplant patients from January 1, 1993, to June 1, 2003, was performed using follow-up records and data submitted to the National Renal Registry. RESULTS...
journal_title:Transplantation proceedings
pub_type: 杂志文章
doi:10.1016/j.transproceed.2004.08.103
更新日期:2004-09-01 00:00:00
abstract:BACKGROUND:Many living kidney donors are still at risk of chronic kidney disease (CKD) 1 year after nephrectomy. Although some donors still experience poor renal function, many exhibit delayed recovery of renal function afterwards. We studied the factors related to delayed recovery of renal function in patients with CK...
journal_title:Transplantation proceedings
pub_type: 杂志文章
doi:10.1016/j.transproceed.2018.01.038
更新日期:2018-05-01 00:00:00
abstract::Cyclosporine has a narrow therapeutic window requiring close monitoring to ensure adequate immunosuppression while avoiding nephrotoxicity and other side effects. Pharmacokinetic studies have suggested that cyclosporine levels at 2 hours postdose (C2) is the best single time point to predict area under the concentrati...
journal_title:Transplantation proceedings
pub_type: 杂志文章
doi:10.1016/j.transproceed.2009.06.155
更新日期:2009-07-01 00:00:00
abstract::Highly active antiretroviral therapy (HAART) has significantly reduced mortality, and prolonged life expectancy of human immunodeficiency virus (HIV)-positive patients. Such improvements have led to increasing numbers of HIV-infected patients with end-stage organ disease as potential candidates for transplantation. A ...
journal_title:Transplantation proceedings
pub_type: 杂志文章
doi:10.1016/j.transproceed.2009.06.186
更新日期:2009-11-01 00:00:00
abstract:BACKGROUND:Invasive aspergillosis (IA) is a rare condition that generally affects immunosuppressed patients. The mortality of IA is known to be >90% in liver transplantation (LT) recipients; the lung is the most commonly affected organ, followed by the brain. There have been reports in the literature of cerebral asperg...
journal_title:Transplantation proceedings
pub_type: 杂志文章
doi:10.1016/j.transproceed.2017.09.013
更新日期:2017-12-01 00:00:00
abstract:INTRODUCTION:Anatomy of the renal artery is an important issue in the renal transplantation era. Multi-detector computed tomography angiography (MDCTA) is an accurate modality for the preoperative assessment of live renal donors, and it provides excellent details of donor arterial anatomy. We studied the relationship b...
journal_title:Transplantation proceedings
pub_type: 杂志文章
doi:10.1016/j.transproceed.2007.11.053
更新日期:2008-01-01 00:00:00
abstract::The purpose of our report is to present the long-term outcomes of three renal transplant recipients with high-grade stenosis and suboptimal percutaneous angioplasty (PTA) because of technical difficulties. Two men and one woman of age 67, 53, and 54 years, who maintained functional cadaveric graft for 17, 9, and 13 ye...
journal_title:Transplantation proceedings
pub_type: 杂志文章
doi:10.1016/j.transproceed.2003.10.003
更新日期:2003-12-01 00:00:00
abstract::Proper maintenance of immunosuppression is required to achieve long-term graft survival. The aim of this study was to evaluate the effect of change or modulation of an immunosuppressive regimen (IR) on graft survival during the posttransplant period in patients undergoing kidney transplantation. A total of 1164 patien...
journal_title:Transplantation proceedings
pub_type: 杂志文章
doi:10.1016/j.transproceed.2010.10.021
更新日期:2010-12-01 00:00:00
abstract:INTRODUCTION:Distance from a liver transplant (LT) center does not affect post-transplant outcomes. Rural areas have lower rates of listing and receiving solid organ transplants. The aim of this study was to investigate trends in referral for LT based on physician-dependent variables. METHODS:An online survey was dist...
journal_title:Transplantation proceedings
pub_type: 杂志文章
doi:10.1016/j.transproceed.2020.01.015
更新日期:2020-04-01 00:00:00
abstract::Autosomal dominant polycystic kidney disease (ADPKD) is characterized by the progressive development of innumerable cysts in both kidneys, which distort the normal kidney architecture, leading to a loss of renal function that may necessitate renal replacement therapy and/or kidney transplantation. In experimental anim...
journal_title:Transplantation proceedings
pub_type: 杂志文章
doi:10.1016/j.transproceed.2009.06.097
更新日期:2009-07-01 00:00:00
abstract::Outflow obstruction may lead to liver congestion and eventual graft failure after living donor liver transplantation. Various methods of venoplasty provide wider outflow tracts. Most series have suggested use of autologous or allogenic grafts for patch venoplasty. We used a polytetrafluorethylene patch in two patients...
journal_title:Transplantation proceedings
pub_type: 杂志文章
doi:10.1016/j.transproceed.2008.07.035
更新日期:2008-10-01 00:00:00
abstract::Liver transplantation for the treatment of patients with advanced liver disease is organized according to a waiting list taking into account different criteria. The agreed distribution model in Andalusia assumes that sometimes an organ is extracted in a different province to that where the implantation is to be perfor...
journal_title:Transplantation proceedings
pub_type: 杂志文章
doi:10.1016/j.transproceed.2013.10.032
更新日期:2013-01-01 00:00:00
abstract:INTRODUCTION:Lung tumors have been related to tobacco and alcohol. The incidence increases after orthotopic liver transplantation (OLT) especially when it is performed because of alcoholic cirrhosis. PATIENTS AND METHODS:We analyzed the incidence and risk factors for de novo lung tumors among 701 patients who underwen...
journal_title:Transplantation proceedings
pub_type: 杂志文章
doi:10.1016/j.transproceed.2005.10.041
更新日期:2005-11-01 00:00:00
abstract::Spontaneous rupture of hepatocellular carcinoma (HCC), defined as T4 in TNM stage by the American Joint Committee on Cancer (eighth edition), is a serious life-threatening complication. Effective treatment remains challenging because of a high 1-month mortality, a short median survival, and the potential of peritoneal...
journal_title:Transplantation proceedings
pub_type: 杂志文章
doi:10.1016/j.transproceed.2019.01.125
更新日期:2019-06-01 00:00:00
abstract:INTRODUCTION:Infections are one of the main complications that cause morbidity and mortality in cardiac transplant recipients. We sought to establish the incidence of infections, identify the predisposing factors and determine their consequences. PATIENTS:A prospective study of 30 patients who received cardiac transpl...
journal_title:Transplantation proceedings
pub_type: 杂志文章
doi:10.1016/j.transproceed.2006.08.087
更新日期:2006-10-01 00:00:00
abstract:BACKGROUND:The safety of the living donor in living-donor liver transplantation (LDLT) is always the first priority, meanwhile, the graft-to-recipient weight ratio (GRWR) and the anatomy of the liver allograft must also not be compromised in order to warrant tranplatation success. When it comes to the allograft of the ...
journal_title:Transplantation proceedings
pub_type: 杂志文章
doi:10.1016/j.transproceed.2018.04.050
更新日期:2018-11-01 00:00:00
abstract:BACKGROUND:Chest computed tomography (CT) as a primary screening method in candidates for living donor liver transplantation (LDLT) is not yet a standardized procedure. The aim of this study is to present our methods and result of evaluation of pulmonary small nodules (PSN) after CT as a primary screening tool. PATIEN...
journal_title:Transplantation proceedings
pub_type: 杂志文章
doi:10.1016/j.transproceed.2015.08.046
更新日期:2016-05-01 00:00:00
abstract::Since November 1974, heterotopic cardiac transplants have been performed at this unit in preference to orthotopic transplants. A number of reasons have led us to prefer this technique, namely donor malfunction in the immediate postoperative period and during rejection; right ventricular failure of the donor heart in t...
journal_title:Transplantation proceedings
pub_type: 杂志文章
doi:
更新日期:1979-03-01 00:00:00