Abstract:
:Optimization of maintenance immunosuppression (mIS) regimens in the transplant recipient requires a balance between sufficient potency to prevent rejection and avoidance of excessive immunosuppression to prevent toxicities and complications. The optimal regimen after simultaneous liver-kidney (SLK) transplantation remains unclear, but small single-center reports have shown success with steroid-sparing regimens. We studied 4184 adult SLK recipients using the Scientific Registry of Transplant Recipients, from March 1, 2002, to February 28, 2017, on tacrolimus-based regimens at 1 year post-transplant. We determined the association between mIS regimen and mortality and graft failure using Cox proportional hazard models. The use of steroid-sparing regimens increased post-transplant, from 16.1% at discharge to 88.0% at 5 years. Using multi-level logistic regression modeling, we found center-level variation to be the major contributor to choice of mIS regimen (ICC 44.5%; 95% CI: 36.2%-53.0%). In multivariate analysis, use of a steroid-sparing regimen at 1 year was associated with a 21% decreased risk of mortality compared to steroid-containing regimens (aHR 0.79, P = .01) and 20% decreased risk of liver graft failure (aHR 0.80, P = .01), without differences in kidney graft loss risk (aHR 0.92, P = .6). Among SLK recipients, the use of a steroid-sparing regimen appears to be safe and effective without adverse effects on patient or graft survival.
journal_name
Clin Transplantjournal_title
Clinical transplantationauthors
Weeks SR,Luo X,Toman L,Gurakar AO,Naqvi FF,Alqahtani SA,Philosophe B,Cameron AM,Desai NM,Ottmann SE,Segev DL,Garonzik-Wang Jdoi
10.1111/ctr.14036subject
Has Abstractpub_date
2020-10-01 00:00:00pages
e14036issue
10eissn
0902-0063issn
1399-0012journal_volume
34pub_type
杂志文章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::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:BACKGROUND:Tracheostomy is an important adjunct for lung transplant patients requiring prolonged ventilation. We explored the effects of post-transplant tracheostomy on survival and bronchiolitis obliterans syndrome after lung transplant. METHODS:A retrospective, single center analysis was performed on all lung transp...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/ctr.13766
更新日期:2020-01-01 00:00:00
abstract:INTRODUCTION:Alagille syndrome (AGS) is an inherited multisystem disorder, and liver transplantation (LT) may be required in pediatric patients with AGS (P-AGS). There are limited data regarding the outcomes of LT in adults with AGS (A-AGS). AIM:To determine and compare the outcomes of LT in A-AGS vs. P-AGS as well as...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/j.1399-0012.2011.01574.x
更新日期:2012-03-01 00:00:00
abstract::Obesity has reached epidemic proportions in the USA. Consequently, there are an increasing number of potential organ donors that are obese, but would otherwise be appropriate donors for pancreas transplantation (PTx). This is a retrospective study of all PTx performed at Indiana University between 2003 and 2009 (n = 3...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/j.1399-0012.2011.01419.x
更新日期:2011-05-01 00:00:00
abstract::Reducing acute care utilization is a means of improving long-term patient outcomes. We sought to assess high inpatient (IP) admission and standalone emergency department (ED) utilization within a 9-month period post-kidney transplantation and to identify mutable factors to reduce utilization. In this ten-year retrospe...
journal_title:Clinical transplantation
pub_type: 临床试验,杂志文章
doi:10.1111/ctr.13522
更新日期:2019-05-01 00:00:00
abstract::Subclinical acute rejection (SAR) occurs in about 30% of stable renal transplant patients and may be a risk factor for a poor allograft outcome. In the present study, the prevalence and clinical features of subclinical rejection, and the expression of immune activation markers in surveillance graft biopsies were asses...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/j.1399-0012.2004.00170.x
更新日期:2004-08-01 00:00:00
abstract:INTRODUCTION:Previously, increasing age has been a part of the exclusion criteria used when determining eligibility for a pancreas transplant. However, the analysis of pancreas transplantation outcomes based on age groupings has largely been based on single-center reports. METHODS:A UNOS database review of all adult p...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/ctr.12407
更新日期:2014-09-01 00:00:00
abstract::Accurate prognostic indicators are lacking for livers with early marginal graft function, making the decision to re-transplant a difficult one. Therefore, we studied 99mTc-labeled DISIDA scanning as a predictor of recovery of marginal grafts. Records of 28 liver transplant recipients with prolonged periods of marginal...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:
更新日期:1994-02-01 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 amount of irreversible injury on renal allograft biopsy predicts function, but little is known about the early evolution of this damage. In a single-center cohort, we examined the relationship between donor-, recipient-, and transplantation-associated factors and change in a morphometric index of chronic damage (I...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/ctr.12251
更新日期:2013-11-01 00:00:00
abstract:BACKGROUND:The purpose of this work was to investigate the association of vertebral and peripheral fractures 10 yr after grafting with bone metabolic markers and body mass density (BMD). PATIENTS AND METHODS:One hundred thirty-eight recipients with stable graft function were included in a cross-sectional study. Graft ...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/ctr.12666
更新日期:2016-02-01 00:00:00
abstract::Post-transplant bone disease is common in solid organ recipients; however, there is limited information on their pre-transplant bone status. We aimed to compare bone mineral density (BMD) in different categories of patients with end-stage organ failure awaiting transplantation (Tx) in Norway. Overall 291 adult patient...
journal_title:Clinical transplantation
pub_type: 临床试验,杂志文章
doi:10.1111/j.1399-0012.2010.01231.x
更新日期:2010-09-01 00:00:00
abstract:BACKGROUND/AIM:The aim of this study was to determine whether the expression of CD25, CD28 and CD38 (which reflects the degree of T-cell activation) by peripheral blood mononuclear cells constitutes a useful means of measuring the immune status of liver transplant recipients. METHODS:Fifty-two patients enrolled in a p...
journal_title:Clinical transplantation
pub_type: 杂志文章,随机对照试验
doi:10.1111/j.1399-0012.2008.00815.x
更新日期:2008-07-01 00:00:00
abstract::Renal transplantation remains the definitive treatment for end-stage renal disease (ESRD). The shorter renal vein in right donor nephrectomies is associated with higher incidence of technical failure. We present here our experience with autologous internal jugular vein (IJV) conduits to facilitate living-donor transpl...
journal_title:Clinical transplantation
pub_type: 临床试验,杂志文章
doi:10.1111/ctr.13312
更新日期:2018-08-01 00:00:00
abstract:BACKGROUND:Mycobacterium tuberculosis (TB) is a common pathogen worldwide, and it may cause significant infection after solid organ transplantation (SOT). We reviewed all reported TB cases to provide an update on its epidemiology, clinical presentation, management, and outcome after SOT. METHODS:MEDLINE, EMBASE, and O...
journal_title:Clinical transplantation
pub_type: 杂志文章,评审
doi:10.1111/ctr.13259
更新日期:2018-06-01 00:00:00
abstract::The purpose of this review was to evaluate the case reports with lymphoproliferative disorders exclusively localized in the allograft transplanted kidney. We also report a rare case of diffuse large B-cell lymphoma originated from the lymphocytes of the recipient with exclusive localization in the kidney allograft. We...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/j.1399-0012.2008.00804.x
更新日期:2008-07-01 00:00:00
abstract::We have developed a practical conditioning regimen without anti-thymocyte globulin (ATG), irradiation, or other myeloablative alkylating agent for low-income countries in which patients with severe aplastic anemia (SAA), who usually have heavily transfused and a prolonged disease history. The application of ATG, Busul...
journal_title:Clinical transplantation
pub_type: 临床试验,杂志文章
doi:10.1111/ctr.12061
更新日期:2013-03-01 00:00:00
abstract::Citrullinaemia is a rare autosomal recessive disorder due to a deficiency of argininosuccinate synthetase (ASS). While the clinical course of the adult onset form (Type II) is unpredictable, many patients undergo sudden deterioration with progressive cerebral oedema. Two patients with Type II citrullinaemia were refer...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:
更新日期:1997-10-01 00:00:00
abstract::Although steroid avoidance and withdrawal in renal transplant recipients (RTR) are actively being evaluated by physicians, the attitudes of recipients toward steroid use have not been systematically studied in the modern era. We conducted a confidential written survey of single-organ adult RTR pertaining to prednisone...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1034/j.1399-0012.2003.00034.x
更新日期:2003-04-01 00:00:00
abstract::These updated guidelines from the Infectious Diseases Community of Practice of the American Society of Transplantation will review the current state of the art of donor-derived infections. Specifically, the guideline will summarize standardized definitions and approaches to defining imputability, updated data on the e...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/ctr.13547
更新日期:2019-09-01 00:00:00
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, ...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/ctr.13406
更新日期:2018-11-01 00:00:00
abstract:BACKGROUND:We aimed to develop an adapted information-motivation-behavioral skills (IMB) model to describe barriers and facilitators for adherence and self-management among kidney transplant recipients. METHODS:We conducted a review of literature about kidney transplant recipients' knowledge, perceptions, and experien...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/ctr.13862
更新日期:2020-06-01 00:00:00
abstract:BACKGROUND:Stem cell-based therapy has received attention as a possible alternative to organ transplantation. The aim of this study was to assess the safety and efficacy of autologous transplantation of bone marrow (BM)-derived stromal cells in post-HCV liver cirrhosis patients. METHODOLOGY:10 × 10(6) of isolated huma...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/ctr.12179
更新日期:2013-07-01 00:00:00
abstract::Xenotransplantation is a potential strategy to overcome the shortage of human donor organs. As this technique has a major medical and psychological impact on patients and their family and friends, the attitude of patients currently waiting for organ transplantation is important. Therefore, we conducted a survey on the...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/j.1399-0012.2010.01296.x
更新日期:2011-05-01 00:00:00
abstract::Vascular complications remain a significant source of morbidity after pancreatic transplantation. We describe a pseudoaneurysm of the superior mesenteric artery (SMA) with an arteriovenous fistula (AVF) involving the SMA and the superior mesenteric vein (SMV) discovered and treated surgically in the second week after ...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1034/j.1399-0012.1999.130310.x
更新日期:1999-06-01 00:00:00
abstract::The development of post-transplant lymphoproliferative disorders (PTLD) is a well-recognized complication of solid organ transplantation in patients receiving immunosuppressive therapy. The literature on PTLD in live renal allograft recipients is scarce and most of the data pertains to PTLD in cadaveric transplants. A...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/j.1399-0012.2005.00406.x
更新日期:2005-10-01 00:00:00
abstract:BACKGROUND:We examined the risk of adverse pregnancy outcomes in primiparous kidney donors compared to matched controls. METHODS:Fifty-nine women with a history of kidney donation prior to their first pregnancy with normal renal function and no history of kidney disease, diabetes or chronic hypertension were matched 1...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/ctr.13453
更新日期:2019-01-01 00:00:00
abstract:UNLABELLED:Medicare pays for 80% of the cost of immunosuppressant agents needed within the first 3 years of solid organ transplantation; however, many patients cannot afford the remaining 20%. Furthermore, many patients who are beyond 3 years post-transplantation and have prescription coverage cannot afford the co-paym...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1034/j.1399-0012.2000.140405.x
更新日期:2000-08-01 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