Abstract:
INTRODUCTION:This is a follow-up of a withdrawal study that we previously performed on 104 liver transplant patients in which immunosuppression was gradually withdrawn over a period of 3 years. Eighty-one patients were not able to be withdrawn (rejectors), and 23 patients were successfully weaned off immunosuppression (tolerants). METHODS:In this study, we present their follow-up after the end of the withdrawal study: we compared the results of the tolerant patients (n=23) with those of the rejectors (n=81). Follow-up was until February 2010. RESULTS:Operational tolerant patients were off immunosuppression for an average of 7.27±0.28 years. Patient survival in the tolerant and the rejector groups was 63.66% and 74.25%, respectively (P=not significant). A patient in the rejector group received two retransplants for chronic rejection. In the rejector group, 19 patients presented 26 rejection episodes: clinically suspected (n=19) and biopsy-proven mild (n=4), moderate (n=2), and severe (n=1) rejection episodes. A tolerant patient had a moderate rejection episode of 5.3 years after immunosuppression withdrawal. In the rejector group, five patients received a kidney transplant and four more are on dialysis versus a tolerant patient on dialysis. Freedom from rejection in the tolerant and rejector groups was 95% and 73%, respectively (P<0.05), and freedom from renal replacement treatment was 83.33% vs. 44.58%, respectively (P=not significant). CONCLUSIONS:Long-term outcomes of operationally tolerant liver transplant patients are at least as good as those of control patients. Operational tolerance is not a permanent state, and continuous vigilance is required to detect rejection episodes.
journal_name
Transplantationjournal_title
Transplantationauthors
Tryphonopoulos P,Ruiz P,Weppler D,Nishida S,Levi DM,Moon J,Tekin A,Velez M,Neuman DR,Island E,Selvaggi G,Tzakis AGdoi
10.1097/TP.0b013e3182003db7subject
Has Abstractpub_date
2010-12-27 00:00:00pages
1556-61issue
12eissn
0041-1337issn
1534-6080journal_volume
90pub_type
杂志文章相关文献
TRANSPLANTATION文献大全abstract::Allotransplantation into immunosuppressed individuals results in long-term survival of grafts. However, the grafts are damaged, probably at many stages before, during and after implantation. The hypothesis to be presented is that release of antigens and autoantigens from the chronically damaged graft results in breaki...
journal_title:Transplantation
pub_type: 杂志文章,评审
doi:10.1097/01.tp.0000153294.38939.5f
更新日期:2005-02-15 00:00:00
abstract::Of 113 cyclosporine-treated primary renal allograft recipients, 60 were randomized to receive standard therapy without diltiazem (ND) and 53 received standard therapy plus diltiazem (D). There was no difference in CsA blood levels between ND and D at all intervals between 3 and 24 months follow-up, yet the D group req...
journal_title:Transplantation
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00007890-199302000-00014
更新日期:1993-02-01 00:00:00
abstract::Recent reports have demonstrated that humoral factors, especially antibodies elicited by xenoantigens, play an important role in the rejection of concordant cardiac xenografts. These induced antibodies, however, have not been well characterized. Therefore, we investigated the rejection mechanism, especially the role o...
journal_title:Transplantation
pub_type: 杂志文章
doi:
更新日期:1994-06-15 00:00:00
abstract:BACKGROUND:Little is known about innate lymphoid cell (ILC) populations in the human gut, and the turnover of these cells and their subsets after transplantation has not been described. METHODS:Intestinal samples were taken from 4 isolated intestine and 3 multivisceral transplant recipients at the time of any operativ...
journal_title:Transplantation
pub_type: 杂志文章
doi:10.1097/TP.0000000000001593
更新日期:2017-10-01 00:00:00
abstract::The purpose of this study was to determine the changes of hepatic sinusoidal endothelial cell (SEC) function in acute liver rejection with respect to receptor-mediated endocytosis. Orthotopic rat liver transplantation was performed in Lewis rats grafted with DA livers and in Lewis rats grafted with Lewis livers as rej...
journal_title:Transplantation
pub_type: 杂志文章
doi:10.1097/00007890-199401000-00006
更新日期:1994-01-01 00:00:00
abstract:OBJECTIVE:Exact knowledge of biliary anatomy is essential in living donor liver transplantation. The purpose of this study was to evaluate the accuracy of pretransplant magnetic resonance cholangiography (MRC) in depicting the biliary anatomy in comparison with intraoperative cholangiography (IOC). MATERIALS AND METHO...
journal_title:Transplantation
pub_type: 杂志文章
doi:10.1097/TP.0b013e31821c1e33
更新日期:2011-07-15 00:00:00
abstract:BACKGROUND:Conflicting data have been reported about the effect of Toxoplasma serostatus on mortality after heart transplantation. Either a positive or a negative recipient Toxoplasma serostatus was found to be associated with increased mortality. METHODS:We evaluated the effects of T. gondii infection on survival of ...
journal_title:Transplantation
pub_type: 杂志文章
doi:10.1097/TP.0b013e3182a9274a
更新日期:2013-12-27 00:00:00
abstract::In the literature, varying terminology for living organ donation can be found. However, there seems to be a need for a new classification to avoid confusion. Therefore, we assessed existing terminology in the light of current living organ donation practices and suggest a more straightforward classification. We propose...
journal_title:Transplantation
pub_type: 社论
doi:10.1097/TP.0b013e3182129236
更新日期:2011-05-15 00:00:00
abstract:BACKGROUND:The hepatic arteries (HAs) in a hepatic graft are usually reconstructed using the recipient's left or right HAs in living donor liver transplantation (LDLT). There have been no apparent selection criteria concerning which of the recipient's HAs should be used. This study retrospectively investigated whether ...
journal_title:Transplantation
pub_type: 杂志文章
doi:10.1097/tp.0b013e3181ce77c4
更新日期:2010-04-27 00:00:00
abstract::LEW rats with long-surviving (> 100 days) (DA x LEW)F1 kidney allografts were generated by treating the recipients with cyclosporine for 14 days after grafting. All rats were monitored after transplantation for the development of antibodies to intact donor class I MHC molecules. Cyclosporine completely suppressed the ...
journal_title:Transplantation
pub_type: 杂志文章
doi:10.1097/00007890-199605270-00007
更新日期:1996-05-27 00:00:00
abstract::In light of the transplant community's efforts to increase living donation, preserving donor autonomy is essential. Understanding how often and the reasons why potential living kidney donors opt out of the donor evaluation process for nonmedical reasons is important for assessing donor voluntariness. The experiences o...
journal_title:Transplantation
pub_type: 杂志文章,评审
doi:10.1097/TP.0000000000001408
更新日期:2016-12-01 00:00:00
abstract:BACKGROUND:Individuals undergoing therapeutic immunosuppression are at risk of severe varicella-zoster virus (VZV) infection, particularly those without evidence of previous infection. METHODS:Eleven children, median age 10 months (range 5.5 months to 7 years and 9 months) received one dose of varicella vaccine (Varil...
journal_title:Transplantation
pub_type: 杂志文章
doi:10.1097/00007890-200011150-00023
更新日期:2000-11-15 00:00:00
abstract::For many individuals suffering from end-stage liver disease (ESLD), the only treatment option is liver transplantation. However, liver transplant rejection is observed in 24-80% of transplant patients and lifelong drug regimens that follow the transplant procedure lead to serious side effects. Furthermore, the pool of...
journal_title:Transplantation
pub_type: 杂志文章
doi:10.1097/TP.0000000000003598
更新日期:2021-01-06 00:00:00
abstract:BACKGROUND:Vaccine-preventable viral infections are associated with increased risk of morbidity and mortality in immunocompromised patients. Current guidelines recommend routine screening and vaccination of all patients before solid organ transplantation. We studied rates of immunity against vaccine-preventable viruses...
journal_title:Transplantation
pub_type: 杂志文章
doi:10.1097/TP.0000000000002722
更新日期:2019-11-01 00:00:00
abstract:BACKGROUND:Infants (<12 months) who require liver transplantation (LTx) represent a particularly challenging and understudied group of patients. METHODS:This retrospective study aimed to describe a large single-center experience of infants who received isolated LTx, illustrate important differences in infants versus o...
journal_title:Transplantation
pub_type: 杂志文章
doi:10.1097/TP.0b013e3181c5cdc1
更新日期:2010-03-15 00:00:00
abstract:BACKGROUND:To determine the prevalence of GB virus-C/hepatitis G virus (GBV-C/HGV) infection in liver transplant recipients transplanted for non-hepatitis C virus indications, 44 patients transplanted for cryptogenic, autoimmune, hepatitis B, or cholestatic liver disease and 91 non-liver transplantation (LT) patients w...
journal_title:Transplantation
pub_type: 杂志文章
doi:10.1097/00007890-199706150-00028
更新日期:1997-06-15 00:00:00
abstract::Non-A, non-B hepatitis is a significant cause of liver disease among renal allograft recipients. In order to assess the impact and prevalence of hepatitis C in a series of renal allograft recipients, we retrospectively screened 621 consecutive patients transplanted between 1979 and 1989 and 484 cadaver organ donors re...
journal_title:Transplantation
pub_type: 杂志文章
doi:10.1097/00007890-199102000-00024
更新日期:1991-02-01 00:00:00
abstract:BACKGROUND:The ability to induce tolerance, or at least minimize the need for immunosuppressive therapy, is a high priority in organ transplantation. Accomplishing this goal requires a novel method for determining when a patient has become tolerant to or is rejecting their graft. Here, we sought to develop an efficient...
journal_title:Transplantation
pub_type: 杂志文章
doi:10.1097/TP.0b013e3182696a5b
更新日期:2012-10-27 00:00:00
abstract:BACKGROUND:Both number and origin (donor vs. host) of dendritic cells (DC) are associated with acute graft-versus-host disease (aGvHD), relapse and graft failure after human allogeneic hematopoietic cell transplantation (aHCT). METHODS:We prospectively and simultaneously investigated skin and blood DC subtypes, their ...
journal_title:Transplantation
pub_type: 杂志文章
doi:10.1097/01.tp.0000203318.16224.57
更新日期:2006-03-27 00:00:00
abstract:BACKGROUND:Many recipients of lung transplants from brain-dead donors develop bronchiolitis obliterans, a manifestation of chronic rejection. It has been shown that brain death increases inflammatory mediators and accelerates acute rejection in kidney, liver, and heart transplants. In this study, the authors investigat...
journal_title:Transplantation
pub_type: 杂志文章
doi:10.1097/01.tp.0000142679.45418.96
更新日期:2004-11-15 00:00:00
abstract::Natural anti-carbohydrate antibodies are central to hyperacute rejection in ABO-incompatible allotransplantation and in discordant xenotransplantation. ABO-incompatible rejection has been inhibited successfully using intravenous soluble carbohydrates as antibody inhibitors. The approach has been less successful previo...
journal_title:Transplantation
pub_type: 杂志文章
doi:
更新日期:1995-12-15 00:00:00
abstract::Conjugation of dextran-coated superparamagnetic iron oxide (SPIO) particles with transactivator protein (Tat)-peptide and fluorescein isothiocyanate (FITC) allows cells to readily uptake SPIO particles. This makes possible high-resolution, real-time imaging of these cells by magnetic resonance imaging (MRI). First, we...
journal_title:Transplantation
pub_type: 杂志文章
doi:10.1097/01.TP.0000090164.42732.47
更新日期:2003-10-15 00:00:00
abstract::Hemorrhagic cystitis is a well known complication of allogeneic bone marrow transplantation (BMT) and is normally attributed to the use of high-dose cyclophosphamide in the preparative regimen. Hemorrhagic cystitis occurring late after BMT is unlikely to be due to the effects of this conditioning, and probably has an ...
journal_title:Transplantation
pub_type: 杂志文章
doi:10.1097/00007890-198701000-00024
更新日期:1987-01-01 00:00:00
abstract::In a murine strain combination disparate in both H-2 antigens and minor histocompatibility antigens consisting of C57BL/6 (B6; H-2b, Mls-1b) mice as recipients and AKR/J (AKR; H-2k, Mls-1a) mice as donors, we reported that the administration of anti-TCR-alpha beta mAb nonspecifically suppresses the ability to reject a...
journal_title:Transplantation
pub_type: 杂志文章
doi:
更新日期:1995-02-15 00:00:00
abstract:BACKGROUND:ABO-incompatible organ transplantation typically induces hyperacute rejection. A2-to-O liver transplantations have been successful. This study compared overall and graft survival in O recipients of A2 and O grafts based on Organ Procurement and Transplantation Network data. METHODS:Scientific Registry of Tr...
journal_title:Transplantation
pub_type: 杂志文章
doi:10.1097/TP.0b013e31825c591e
更新日期:2012-09-15 00:00:00
abstract:BACKGROUND:We recently described a new approach that enables the generation of human/mouse chimera by adoptive transfer of human peripheral blood mononuclear cells into lethally irradiated normal strains of mice or rats, radioprotected with bone marrow from donors with severe combined immune deficiency. In such human/m...
journal_title:Transplantation
pub_type: 杂志文章
doi:10.1097/00007890-199704270-00018
更新日期:1997-04-27 00:00:00
abstract::We have previously observed that transplant recipient sera with endothelial antibodies are bound to epidermal cells, as shown by immunofluorescence on sections of skin. It was also reported that early kidney failures that occurred despite negative T cell crossmatches were associated with, and could have been predicted...
journal_title:Transplantation
pub_type: 杂志文章
doi:10.1097/00007890-199102000-00019
更新日期:1991-02-01 00:00:00
abstract:BACKGROUND:The induction of tolerance to pig antigens in primates may facilitate the development of successful clinical xenotransplantation protocols. The infusion of mobilized porcine peripheral blood leukocytes (PBPCs, comprised of approximately 2% peripheral blood progenitor cells) into splenectomized preconditioned...
journal_title:Transplantation
pub_type: 杂志文章
doi:10.1097/00007890-200110150-00021
更新日期:2001-10-15 00:00:00
abstract:BACKGROUND:Patients with high tacrolimus clearance eliminate more drug within a dose interval compared with those with low clearance. Delays in dosing time will result in transient periods of lower concentrations in high versus low clearance patients. Transient subtherapeutic tacrolimus concentrations may induce acute ...
journal_title:Transplantation
pub_type: 杂志文章
doi:10.1097/TP.0000000000001796
更新日期:2017-08-01 00:00:00
abstract:BACKGROUND:Socioeconomic variables including low income and noncompliance impact negatively upon long-term renal allograft survival, especially in African Americans. We sought to determine whether other socioeconomic variables contributed to noncompliance and allograft survival. METHODS:A detailed history of socioecon...
journal_title:Transplantation
pub_type: 杂志文章
doi:10.1097/00007890-200107270-00017
更新日期:2001-07-27 00:00:00