Abstract:
:Renal transplant patients lose their grafts most frequently from chronic allograft nephropathy and their lives from cardiac disease, malignancy, and infection. These are thus the challenges for renal transplant programs for this decade, just as acute rejection was the challenge of the last two decades. Most immunosuppressive protocols aim to minimize acute allograft rejection through heavy induction strategies and powerful but toxic maintenance therapies, counterbalanced by powerful and expensive infection prophylaxis. However, while the short-term results have improved steadily from the 1980s, and despite all the current efforts, the long-term success rates of renal transplants have not improved. Future aims include controlling both rejection and the long-term consequences of toxicity and infection risk. The biological facts that have determined our approach to the use of immunosuppressants have required us to try to balance the conflicting need for control of the allograft response and the inevitable toxicities of our drugs. The early period after transplantation requires maximum immunosuppressive efficacy with minimal ischemia reperfusion and good surgical-related wound healing. The latter period after transplantation requires less immunosuppressive efficacy and avoidance of chronic nephrotoxicity, cardiovascular, and malignancy risk factors. This usually leads to an induction strategy using a biological agent; a calcineurin inhibitor; an antiproliferative agent; and variable use of corticosteroids. In the long term, there are a variety of strategies for dose reduction or elimination of calcineurin inhibitors, incorporation of mammalian target of rapamycin inhibitors, and variable approaches to the risks of continued low-dose corticosteroids. The multiplicity of alternative strategies available testifies to the absence of evidence for a single dominant protocol and the urgent need to determine the relevant early indicators for measuring long-term success.
journal_name
Transplant Procjournal_title
Transplantation proceedingsauthors
Chapman Jdoi
10.1016/j.transproceed.2008.10.003subject
Has Abstractpub_date
2008-12-01 00:00:00pages
S2-4issue
10 Suppleissn
0041-1345issn
1873-2623pii
S0041-1345(08)01355-9journal_volume
40pub_type
杂志文章abstract::In the same animal, following HS and recovery, pancreatic islet function remains intact while immunologic functions are impaired. Cellular responses to thermal stresses are complex and tissue specific. ...
journal_title:Transplantation proceedings
pub_type: 杂志文章
doi:10.1016/s0041-1345(97)00225-x
更新日期:1997-06-01 00:00:00
abstract:PURPOSE:The objective of this research was to survey the therapeutic action of simvastatin (Sim) on intestinal ischemia/reperfusion injury (II/RI) by modulating Omi/HtrA2 signaling pathways. METHODS:Sprague Dawley rats were pretreated with 40 mg/kg Sim and then subjected to 1 hour of ischemia and 3 hours of reperfusio...
journal_title:Transplantation proceedings
pub_type: 杂志文章
doi:10.1016/j.transproceed.2019.04.076
更新日期:2019-10-01 00:00:00
abstract::Hepaticojejunostomy is a good alternative technique for biliary reconstruction in liver transplantation. Among 517 liver transplants performed between March 1992 and July 2005, 33 involved hepaticojejunostomy, namely, 18 men and 12 women of average age: 44.8 years. The main cause for this technique was retransplant (n...
journal_title:Transplantation proceedings
pub_type: 杂志文章
doi:10.1016/j.transproceed.2006.08.001
更新日期:2006-10-01 00:00:00
abstract::The mechanism of the immunosuppressive effect of CyA and FK 506 can be monitored in vivo in humans. The picture emerging is of a close relationship between drug concentrations and CN inhibition. But many puzzles of the drugs remain. What is the role of CyA in the activation of transforming growth factor-beta (TGF-beta...
journal_title:Transplantation proceedings
pub_type: 杂志文章,评审
doi:10.1016/s0041-1345(98)00577-6
更新日期:1998-08-01 00:00:00
abstract::Systemic administration of erythropoietin (Epo) protects the myocardium from an ischemic insult and promotes beneficial remodeling. We hypothesized that intracardiac injection of Epo may exhibit cardioprotective potential with reduced systemic toxicity. Following myocardial infarction (MI), Epo was injected directly i...
journal_title:Transplantation proceedings
pub_type: 杂志文章
doi:10.1016/j.transproceed.2008.03.033
更新日期:2008-05-01 00:00:00
abstract:BACKGROUND:This study sought to describe the long-term nutritional outcomes of children after intestinal transplant (SBT). METHODS:Between 1991 and March 2005, 30 children received 33 SBT at a single center. Eligibility criteria included patient and graft survival >6 months. Weight, height, albumin, prealbumin, zinc (...
journal_title:Transplantation proceedings
pub_type: 杂志文章
doi:10.1016/j.transproceed.2006.05.051
更新日期:2006-07-01 00:00:00
abstract:INTRODUCTION:The aim of the study was to assess the impact of bacterial infection during hospital stay on long-term follow-up. MATERIALS AND METHODS:This was a retrospective single-center study of 97 recipients of lung transplantations performed between December 2004 and June 2016 at a single center. Information about...
journal_title:Transplantation proceedings
pub_type: 杂志文章
doi:10.1016/j.transproceed.2017.11.080
更新日期:2018-09-01 00:00:00
abstract:BACKGROUND:Hepatitis C has been associated with an increased incidence of diabetes mellitus (DM) following renal transplantation (RT). METHODS:Patients who underwent RT between 1985 and 2001 were excluded if they showed DM prior to RT, graft survival of less than 90 days, and unknown anti-HCV status (n=15). Two groups...
journal_title:Transplantation proceedings
pub_type: 杂志文章
doi:10.1016/s0041-1345(03)00611-0
更新日期:2003-08-01 00:00:00
abstract::Budd-Chiari syndrome (BCS) in patients progressing to cirrhosis is an indication for liver transplantation. At this stage of disease, it is common to find large benign hepatocellular nodules (LBHNs) of undetermined cause that may be confused with hepatocellular carcinoma (HCC). Patients with indications for liver tran...
journal_title:Transplantation proceedings
pub_type: 杂志文章
doi:10.1016/j.transproceed.2010.09.070
更新日期:2010-12-01 00:00:00
abstract::We investigated the effects of portocaval shunt (PCS) on excessive portal flow in producing sinusoidal microcirculatory injury in small-for-size liver transplants in pigs. The posterior segment of a whole liver (25%) was transplanted orthotopically. The pigs were divided two groups: group A, graft with PCS (n = 11), a...
journal_title:Transplantation proceedings
pub_type: 杂志文章
doi:10.1016/j.transproceed.2005.01.002
更新日期:2005-01-01 00:00:00
abstract::To minimize bleeding during major liver resections or liver transplantation, surgical measures have been adopted that induce ischemia-reperfusion injury (I/R) which may significantly contribute to morbidity and mortality of partial liver resections. Several methods have sought to minimize I/R hepatic lesions. The pres...
journal_title:Transplantation proceedings
pub_type: 杂志文章
doi:10.1016/j.transproceed.2007.01.011
更新日期:2007-03-01 00:00:00
abstract::Mitomycin-C (MMC) is categorized as an agent that causes genotoxic stress by triggering various intracellular signaling pathways. We have previously shown that MMC pretreatment of highly immunogenic crude islets leads to significant prolongation of graft survival in a rat-to-mouse model. In the present study, we exami...
journal_title:Transplantation proceedings
pub_type: 杂志文章
doi:10.1016/j.transproceed.2004.04.029
更新日期:2004-05-01 00:00:00
abstract:INTRODUCTION:Induction therapy reduces rejection episodes among patients at high immunologic risk. Antithymocyte globulins appear to be superior to basiliximab in this population, despite the greater potential risk of infection and neoplasia. The aim of this study was to evaluate graft function and acute rejection epis...
journal_title:Transplantation proceedings
pub_type: 杂志文章
doi:10.1016/j.transproceed.2013.03.010
更新日期:2013-04-01 00:00:00
abstract::Disseminated invasive aspergillosis is a serious and potentially lethal infectious complication of immunosuppressed individuals, including transplant recipients. We report here a successfully treated case of disseminated Aspergillus fumigatus infection involving the lungs, brain, and endocardium in a multivisceral tra...
journal_title:Transplantation proceedings
pub_type: 杂志文章
doi:10.1016/j.transproceed.2006.10.015
更新日期:2007-01-01 00:00:00
abstract:BACKGROUND:One common complication after kidney transplantation is a lymphocele. The aim of our work was an analysis of incidence of lymphocele and the effectiveness of minimal invasive methods in the management of this complication. MATERIALS AND METHODS:The examined group was consisted of 158 patients (68 female and...
journal_title:Transplantation proceedings
pub_type: 杂志文章
doi:10.1016/j.transproceed.2009.09.045
更新日期:2009-10-01 00:00:00
abstract::We present the case of a 37-year-old patient diagnosed with multiple endocrine neoplasia type 2A (MEN 2A) syndrome, as confirmed by genetic tests, who underwent the transplantation of a kidney from a cadaveric donor. MEN 2A, a hereditary autosomal dominant syndrome, is caused by the mutation of the RET proto-oncogene....
journal_title:Transplantation proceedings
pub_type: 杂志文章
doi:10.1016/j.transproceed.2011.08.018
更新日期:2011-10-01 00:00:00
abstract:INTRODUCTION:Hepatocellular carcinoma (HCC) is the third most common cause of cancer-related death worldwide. Orthotopic liver transplantation (OLT) is the best therapy of choice for early, unresectable HCC. The Hungarian Liver Transplantation Program was launched in 1995 at the Department of Transplantation and Surger...
journal_title:Transplantation proceedings
pub_type: 杂志文章
doi:10.1016/j.transproceed.2015.07.026
更新日期:2015-09-01 00:00:00
abstract:BACKGROUND:The question of whether donor age negatively impacts recipient outcome in adult-to-adult living donor liver transplantation (LDLT) is rarely discussed. The aim of this study was to evaluate the impact of older donor age (50 years or older) on recipient outcomes in adult-to-adult LDLT. METHODS:LDLT data were...
journal_title:Transplantation proceedings
pub_type: 杂志文章
doi:10.1016/j.transproceed.2007.03.116
更新日期:2007-12-01 00:00:00
abstract:BACKGROUND:Cold ischemia and clamping of the renal artery contribute to acute tubular necrosis and renal dysfunction of transplant grafts. The mechanism of ischemic injury is not fully understood, but endothelin (ET)-1 and -2 have been found to participate in reperfusion injury. ET receptor blockade has been shown to h...
journal_title:Transplantation proceedings
pub_type: 杂志文章
doi:10.1016/j.transproceed.2008.02.071
更新日期:2008-06-01 00:00:00
abstract::The safety and efficacy of tacrolimus (Tac)-based immunosuppressive treatments were studied in 115 pediatric renal transplant recipients (mean follow-up period, approximately 20 months). The acute rejection rate was 22.7% 6 months after transplantation and the steroid-resistant acute rejection rate was 6.4%. The 5-yea...
journal_title:Transplantation proceedings
pub_type: 杂志文章,多中心研究
doi:10.1016/j.transproceed.2005.03.071
更新日期:2005-05-01 00:00:00
abstract::This study indicates that (1) ATN adversely affects long-term allograft survival but not patient survival, (2) in patients with delayed function the duration of ATN does not influence allograft survival, (3) ATN kidneys with good recovery (SCR less than 3.0) do as well as immediate-function kidneys, (4) poor recovery ...
journal_title:Transplantation proceedings
pub_type: 杂志文章
doi:
更新日期:1979-03-01 00:00:00
abstract::We analyzed the effectiveness of paravertebral-block for immediate postoperative pain control in living liver donors. Specifically, we sought to determine whether or not the addition of paravertebral catheters with continuous ropivacaine infusion would decrease postoperative opioid use and reduce the incidence of adve...
journal_title:Transplantation proceedings
pub_type: 杂志文章
doi:10.1016/j.transproceed.2016.11.045
更新日期:2017-03-01 00:00:00
abstract::Fulminant hepatic failure (FHF) is often complicated with cerebral edema, intracranial hypertension, and coma. Cytotoxic and vasogenic factors have been recognized in the etiology of cerebral edema. One of the main causes seems to be the accumulation of glutamine in astrocytes, which is produced from ammonia and the e...
journal_title:Transplantation proceedings
pub_type: 杂志文章
doi:10.1016/j.transproceed.2006.01.040
更新日期:2006-04-01 00:00:00
abstract::New-onset diabetes mellitus is associated with considerable morbidity after transplantation. We evaluated 78 living related renal transplant recipients due to all causes except diabetic nephropathy a waiting a living related renal transplantation. We evaluated demographic characteristics, pretransplant glycemic profil...
journal_title:Transplantation proceedings
pub_type: 杂志文章
doi:10.1016/j.transproceed.2010.10.008
更新日期:2010-12-01 00:00:00
abstract:OBJECTIVE:Reperfusion of the ischemic liver results in the generation of oxidative and nitrosative stresses and reaction product of peroxynitrite, which induce rapid cytotoxicity and liver injury. In this study we demonstrated that curcumin, an antioxidant, attenuated ischemia/reperfusion (I/R)-induced liver injury. M...
journal_title:Transplantation proceedings
pub_type: 杂志文章
doi:10.1016/j.transproceed.2012.01.081
更新日期:2012-05-01 00:00:00
abstract:BACKGROUND:Ischemia-reperfusion (IR)-induced nephrotoxicity is associated with proteinuria. There are reports on the involvement of inducible nitric oxide synthase (iNOS) in proteinuria in conjunction with renal disease. This study was designed to investigate the effect of N6-(1-iminoethyl)-L-lysine hydrochloride (L-Ni...
journal_title:Transplantation proceedings
pub_type: 杂志文章
doi:10.1016/j.transproceed.2009.07.014
更新日期:2009-09-01 00:00:00
abstract::Although the number of pancreas transplants has increased significantly in previous years, debate continues concerning the optimum technique for exocrine pancreas drainage. Enteric drainage (ED) has recently been increasingly popular due to the long-term complications with bladder drainage (BD). We prospectively assig...
journal_title:Transplantation proceedings
pub_type: 杂志文章
doi:10.1016/j.transproceed.2004.05.027
更新日期:2004-05-01 00:00:00
abstract:PURPOSE:The family advocate plays a crucial role in the organ and tissue procurement process for transplantation and research. This responsibility can weigh profoundly on the consent/conversion rates for family advocates. Some potential donor families consider time as a critical factor when deciding to donate. It was h...
journal_title:Transplantation proceedings
pub_type: 杂志文章
doi:10.1016/j.transproceed.2008.03.058
更新日期:2008-05-01 00:00:00
abstract::Hyperglycemia is common following renal transplantation. This study was conducted to evaluate the relationship of perioperative serum glucose levels and acute rejection in 100 nondiabetic patients who underwent renal transplantation. Blood glucose was measured immediately following surgery and every 6 hours during the...
journal_title:Transplantation proceedings
pub_type: 杂志文章
doi:10.1016/j.transproceed.2007.03.030
更新日期:2007-05-01 00:00:00
abstract:AIM:Allograft steatosis is an emerging concern after liver transplantation (LT). The use of transient elastography (TE) with controlled attenuation parameter (CAP) may facilitate early detection of and intervention for allograft steatosis. This study aimed to evaluate the prevalence and risk factors of allograft steato...
journal_title:Transplantation proceedings
pub_type: 杂志文章
doi:10.1016/j.transproceed.2020.02.160
更新日期:2021-01-01 00:00:00