Risk-stratified screening for ischemic heart disease in kidney transplant candidates.

Abstract:

BACKGROUND:Few studies have examined the effectiveness of a risk-stratified approach to screening kidney transplantation candidates for ischemic heart disease (IHD). METHODS:We retrospectively reviewed records from all adult patients (n = 514) placed on the deceased donor kidney transplantation waiting list at a single center between January 1992 and June 2000. During this time there was a consistent policy for high-risk patients to undergo noninvasive stress testing and/or coronary angiography. We examined screening tests, the resulting interventions, and the incidence of subsequent IHD events (myocardial infarction, angioplasty, bypass surgery, or IHD death) among those screened and not screened. RESULTS:For 224 (43.6%) low-risk patients who were not screened, the actuarial incidence of an IHD event after listing (before or after transplantation) was only 0.5% at 1 year, 3.5% at 3 years, and 5.3% at 5 years. Screening 290 (56.4%) high-risk patients resulted in prophylactic angioplasty in 18 (6.2%), and bypass surgery in 8 (2.8%) before listing. After listing, 61 patients were screened, resulting in angioplasty in 6 (9.8%) and bypass surgery in 1 (1.6%). Of the 68 patients who ultimately had an IHD event after being placed on the waiting list, only 13 (19.4%) had not been screened. CONCLUSIONS:A risk-stratified screening strategy effectively avoided unnecessary testing in 43.6%. However, the relatively low proportion of screened patients who underwent prophylactic angioplasty or bypass grafting raises the question of whether screening was effective in preventing IHD events.

journal_name

Transplantation

journal_title

Transplantation

authors

Kasiske BL,Malik MA,Herzog CA

doi

10.1097/01.tp.0000173652.87417.ca

subject

Has Abstract

pub_date

2005-09-27 00:00:00

pages

815-20

issue

6

eissn

0041-1337

issn

1534-6080

pii

00007890-200509270-00016

journal_volume

80

pub_type

杂志文章
  • Intravenous immune globulin treatment inhibits crossmatch positivity and allows for successful transplantation of incompatible organs in living-donor and cadaver recipients.

    abstract:BACKGROUND:Sensitization to human leukocyte antigens (HLA) is a significant barrier to transplantation. Currently, no proven therapy exists to improve access to transplantation for highly sensitized patients. Here, we report a novel approach using intravenous immune globulin to modulate anti-HLA antibody and improve th...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/01.TP.0000080685.31697.FC

    authors: Jordan SC,Vo A,Bunnapradist S,Toyoda M,Peng A,Puliyanda D,Kamil E,Tyan D

    更新日期:2003-08-27 00:00:00

  • The role of self-expandable metallic stents for the treatment of airway complications after lung transplantation.

    abstract:BACKGROUND:Airway complications continue to be an important source of morbidity and mortality after lung transplantation (LTx). Different approaches have been used for their nonsurgical management. We describe our experience using self-expandable metallic stents (SEMSs) in patients with airway complications post-LTx. ...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/01.TP.0000061229.83500.A0

    authors: Saad CP,Ghamande SA,Minai OA,Murthy S,Pettersson G,DeCamp M,Mehta AC

    更新日期:2003-05-15 00:00:00

  • Center-level variation in the development of delayed graft function after deceased donor kidney transplantation.

    abstract:BACKGROUND:Patient-level risk factors for delayed graft function (DGF) have been well described. However, the Organ Procurement and Transplantation Network definition of DGF is based on dialysis in the first week, which is subject to center-level practice patterns. It remains unclear if there are center-level differenc...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/TP.0000000000000450

    authors: Orandi BJ,James NT,Hall EC,Van Arendonk KJ,Garonzik-Wang JM,Gupta N,Montgomery RA,Desai NM,Segev DL

    更新日期:2015-05-01 00:00:00

  • Preventing acute rejection, Epstein-Barr virus infection, and posttransplant lymphoproliferative disorders after kidney transplantation: use of aciclovir and mycophenolate mofetil in a steroid-free immunosuppressive protocol.

    abstract:BACKGROUND:A widely held view is that any increase in the potency of an immunosuppressive agent will lead to an increase in infection and malignancy, such as life-threatening Epstein-Barr virus (EBV) induced posttransplant lymphoproliferative disorders (PTLD). We tested this paradigm by studying the effect of adding mo...

    journal_title:Transplantation

    pub_type: 临床试验,杂志文章

    doi:10.1097/00007890-199905150-00002

    authors: Birkeland SA,Andersen HK,Hamilton-Dutoit SJ

    更新日期:1999-05-15 00:00:00

  • Effect of pretransplant erythropoietin therapy on renal allograft outcome.

    abstract::Erythropoietin (EPO) is widely used among patients with end-stage renal disease awaiting transplantation. Data suggest that EPO therapy may be immunomodulatory. The purpose of this study was to assess the effects of pretransplant EPO therapy on renal allograft outcome. We evaluated 120 consecutive renal transplant rec...

    journal_title:Transplantation

    pub_type: 临床试验,杂志文章

    doi:10.1097/00007890-199610150-00024

    authors: Vasquez EM,Pollak R

    更新日期:1996-10-15 00:00:00

  • Hepatic tolerance to hypotension as assessed by the changes in arterial ketone body ratio in the state of brain death.

    abstract::Hepatic tolerance to hypotension was assessed by changes in arterial ketone body ratio (KBR) and hepatic energy charge levels in experimental brain death induced by epidural ballooning in dogs, and compared with the hemorrhagic shock model. Systolic arterial blood pressure was significantly decreased from 182 mmHg to ...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/00007890-198903000-00008

    authors: Lin H,Okamoto R,Yamamoto Y,Maki A,Ueda J,Tokunaga Y,Yamamoto S,Mori K,Tanaka K,Yamaoka Y

    更新日期:1989-03-01 00:00:00

  • Effects of steroid hormones on phytohemagglutinin-stimulated human peripheral blood lymphocytes.

    abstract::The interactions of steroid hormones and human peripheral blood lymphocytes (PBLs) have been investigated following glass-wool column separation of PBLs and incubation in a serum-free medium in the presence of phytohemagglutinin (PHA). Addition of hydrocortisone or progesterone above physiological concentrations resul...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/00007890-197905000-00004

    authors: Neifeld JP,Tormey DC

    更新日期:1979-05-01 00:00:00

  • Therapeutic potential of monoclonal antibodies to the leukocyte-common antigen. Synergy and interference in complement-mediated lysis.

    abstract::A series of rat monoclonal antibodies against the human leukocyte-common antigen were isolated and, by means of competitive binding assays with purified antigen, two distinct groups were defined that recognize different epitopes of the molecule. None of these antibodies were lytic with human complement, but when antib...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/00007890-198511000-00013

    authors: Bindon CI,Hale G,Clark M,Waldmann H

    更新日期:1985-11-01 00:00:00

  • Uncontrolled Donation After Circulatory Death: A Unique Opportunity.

    abstract::Uncontrolled donation after circulatory death (uDCD) refers to donation from persons who die following an unexpected and unsuccessfully resuscitated cardiac arrest. Despite the large potential for uDCD, programs of this kind only exist in a reduced number of countries with a limited activity. Barriers to uDCD are of a...

    journal_title:Transplantation

    pub_type: 杂志文章,评审

    doi:10.1097/TP.0000000000003139

    authors: Coll E,Miñambres E,Sánchez-Fructuoso A,Fondevila C,Campo-Cañaveral de la Cruz JL,Domínguez-Gil B

    更新日期:2020-08-01 00:00:00

  • Pitavastatin suppresses acute and chronic rejection in murine cardiac allografts.

    abstract:INTRODUCTION:HMG-CoA reductase inhibitors play several roles in the maintenance of organ transplants. We investigated the role of pitavastatin, a potent and newly developed HMG-CoA reductase inhibitor, in cardiac allograft rejection and mechanism of graft arterial disease (GAD) suppression. METHODS:Balb/c mice hearts ...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/01.tp.0000259650.67061.16

    authors: Suzuki J,Koga N,Kosuge H,Ogawa M,Haraguchi G,Maejima Y,Saiki H,Isobe M

    更新日期:2007-04-27 00:00:00

  • Emerging Ethical Challenges Raised by the Evolution of Vascularized Composite Allotransplantation.

    abstract:BACKGROUND:Despite early skepticism, the field of vascularized composite allotransplantation (VCA) has demonstrated feasibility. The ethics of VCA have moved past doubts about the morality of attempting such transplants to how to conduct them ethically. METHODS:Leaders of each program performing and/or evaluating VCA ...

    journal_title:Transplantation

    pub_type: 共识发展会议,杂志文章,评审

    doi:10.1097/TP.0000000000002478

    authors: Caplan AL,Parent B,Kahn J,Dean W,Kimberly LL,Lee WPA,Rodriguez ED

    更新日期:2019-06-01 00:00:00

  • Zinc transporter 8 autoantibodies increase the predictive value of islet autoantibodies for function loss of technically successful solitary pancreas transplant.

    abstract:BACKGROUND:Despite the success rate of solitary pancreas transplantation in type 1 diabetes with preserved kidney function has greatly improved in recent years, a residual proportion of failures persists. METHODS:With the aim of investigating autoimmunity as an unrecognized cause of graft failure, we measured autoanti...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/TP.0b013e31822ae65f

    authors: Occhipinti M,Lampasona V,Vistoli F,Bazzigaluppi E,Scavini M,Boggi U,Marchetti P,Bosi E

    更新日期:2011-09-27 00:00:00

  • Primary integumentary allograft reactivity in the American cockroach, Periplaneta americana.

    abstract::Previous reports have failed to demonstrate integumentary allograft rejection in insects. We realized however, that these studies may not have fully appreciated the structure of the insect exoskeleton. Since the subcuticlar epidermal layer constitutes the only living tissue associated with insect integument, its destr...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/00007890-198704000-00012

    authors: George JF,Howcroft TK,Karp RD

    更新日期:1987-04-01 00:00:00

  • Renal allograft survival in patients with oxalosis.

    abstract:BACKGROUND:Primary hyperoxaluria is a rare autosomal recessive metabolic disease that often progresses to end-stage renal disease (ESRD). Liver transplantation is curative for patients with the alanine: glyoxylate aminotransferase deficiency. For oxalosis patients with minor enzyme deficiencies, renal transplantation m...

    journal_title:Transplantation

    pub_type: 杂志文章,多中心研究

    doi:10.1097/00007890-200209150-00020

    authors: Cibrik DM,Kaplan B,Arndorfer JA,Meier-Kriesche HU

    更新日期:2002-09-15 00:00:00

  • Prevention and inhibition but not reversion of chronic allograft vasculopathy by FK778.

    abstract:BACKGROUND:This study aimed at investigating the efficacy of the novel immunosuppressant FK778 to prevent the development and progression of chronic allograft vasculopathy (CAV). METHODS:Orthotopic aortic transplantations were performed in the PVG-to-ACI rat model and followed over the course of 120 days. Immunosuppre...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/TP.0b013e3181673608

    authors: Deuse T,Hoyt G,Koyanagi T,Robbins RC,Schrepfer S

    更新日期:2008-03-27 00:00:00

  • The effects of perioperative portal venous inoculation with donor lymphocytes on renal allograft survival in the rat. II. Phenotypic and functional analyses of graft-infiltrating cells.

    abstract::Phenotype, donor-specific cytolytic activity, and helper activity to release cytokines of cells infiltrating within renal allografts of hosts rendered unresponsive by perioperative administration of donor lymphocytes via the portal vein (p.v.) were investigated in order to analyze the mechanism of prolongation of allo...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/00007890-199001000-00038

    authors: Hamashima T,Yoshimura N,Matsui S,Lee CJ,Ohsaka Y,Oka T

    更新日期:1990-01-01 00:00:00

  • Sequential antilymphoblast globulin and cyclosporine for renal transplantation.

    abstract::The nephrotoxic effects of cyclosporine (CsA) seem to be augmented by co-existing renal injury. A high rate of prolonged delayed function (acute tubular necrosis [ATN]) and non-function (NF) has been associated with the use of CsA prior to and following renal transplantation. Cyclosporine has also been associated with...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/00007890-198701000-00019

    authors: Sommer BG,Henry M,Ferguson RM

    更新日期:1987-01-01 00:00:00

  • Pretransplant IgG subclasses of donor-specific human leukocyte antigen antibodies and development of antibody-mediated rejection.

    abstract:BACKGROUND:The subclass of IgG antibodies contributes to their capability to activate complement. It is currently unknown whether the pretransplant IgG subclass composition allows distinguishing harmful from presumably irrelevant donor-specific human leukocyte antigen (HLA) antibodies (HLA-DSA) detected by single-antig...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/TP.0b013e31821cdf0d

    authors: Hönger G,Hopfer H,Arnold ML,Spriewald BM,Schaub S,Amico P

    更新日期:2011-07-15 00:00:00

  • A prospective study of human herpesvirus type 6 detected by polymerase chain reaction after liver transplantation.

    abstract::Human herpesvirus type 6 (HHV-6) causes roseola infantum (exanthema subitum) upon primary infection in young children. Thereafter it persists lifelong in the organism. Like other herpesviruses, HHV-6 can be reactivated in periods of immunosuppression - e.g., after organ transplantation. In order to study the incidence...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/00007890-199602270-00027

    authors: Schmidt CA,Wilbron F,Weiss K,Brinkmann V,Oettle H,Lohmann R,Langrehr JM,Neuhaus P,Siegert W

    更新日期:1996-02-27 00:00:00

  • HCV Antiviral Therapy in Liver Transplant Candidates and Recipients With Renal Insufficiency.

    abstract::Hepatitis C virus (HCV) remains the leading indication for liver transplant in much of the world and has traditionally been associated with diminished posttransplant survival due to recurrent HCV-related liver disease. This field has been dramatically changed by the advent of safe and effective direct-acting antiviral...

    journal_title:Transplantation

    pub_type: 杂志文章,评审

    doi:10.1097/TP.0000000000001688

    authors: Verna EC,Brown RS Jr

    更新日期:2017-05-01 00:00:00

  • Efficient gene transfer to pancreatic islets mediated by adenoviral vectors.

    abstract::Genetic manipulation of pancreatic islets before transplantation has the potential to alter cellular immunity as well as islet function. The purpose of this study was to examine the feasibility of gene transfer to islets, using replication-defective adenoviral vectors. Newborn mouse islets were infected with AdHCMVsp1...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:

    authors: Csete ME,Benhamou PY,Drazan KE,Wu L,McIntee DF,Afra R,Mullen Y,Busuttil RW,Shaked A

    更新日期:1995-01-27 00:00:00

  • Sirolimus inhibits oxidative burst activity in transplant recipients.

    abstract::Increased susceptibility to bacterial infection is a recognized side-effect of sirolimus treatment after transplantation, which could be caused by inhibition of neutrophil activation. Blood from 24 healthy subjects was equilibrated with 0 to 50 ng/mL sirolimus or 60 microg/mL propofol. Blood was also collected from 23...

    journal_title:Transplantation

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1097/01.TP.0000093995.08240.49

    authors: Gee I,Trull AK,Charman SC,Alexander GJ

    更新日期:2003-12-27 00:00:00

  • The impact of cyclosporine dose reduction with or without the addition of rapamycin on functional, molecular, and histological markers of chronic allograft nephropathy.

    abstract:BACKGROUND:Overexposure to cyclosporine is a risk factor for chronic allograft nephropathy (CAN) and dose reduction has been advocated. The purpose of this study was to determine the impact of adding the non-nephrotoxic immunosuppressant, rapamycin, after cyclosporine dose reduction in renal-allograft recipients with C...

    journal_title:Transplantation

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1097/00007890-200303270-00008

    authors: Saunders RN,Bicknell GR,Nicholson ML

    更新日期:2003-03-27 00:00:00

  • Risk score predicting decline in renal function postliver transplant: role in patient selection for combined liver kidney transplantation.

    abstract:BACKGROUND:A combined liver and kidney transplantation (CLKT) is advocated for selected individuals with chronic kidney disease undergoing liver transplantation (LT). The aim was to develop a risk score to identify the patients whose estimated glomerular filtration rate (eGFR) would decline during the year post-LT to a...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/TP.0b013e3181d9e195

    authors: O'Riordan A,Donaldson N,Cairns H,Wendon J,O'Grady JG,Heaton N,Hendry BM

    更新日期:2010-06-15 00:00:00

  • Predictive role of pretransplant serum CXCL10 for cardiac acute rejection.

    abstract:BACKGROUND:The detection of acute rejection in heart transplantation remains an important feature of transplant management, especially in the early phase. Frequent surveillance with endomyocardial biopsy is necessary, even though it is an invasive procedure and carries a certain risk. Hence, noninvasive biomarkers able...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/TP.0b013e3181919f5d

    authors: Crescioli C,Buonamano A,Scolletta S,Sottili M,Francalanci M,Giomarelli P,Biagioli B,Lisi G,Pradella F,Serio M,Romagnani P,Maccherini M

    更新日期:2009-01-27 00:00:00

  • The frequency of rejection episodes after combined kidney-pancreas transplant--the impact on graft survival.

    abstract::The recipients of combined kidney-pancreas transplants (SPK) are unique because they routinely receive two allografts from the same donor. In a previous study, we found that the long-term graft survival of the two allografts was different, with better graft survival seen in the pancreas allograft. In an attempt to und...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/00007890-199408270-00006

    authors: Tesi RJ,Henry ML,Elkhammas EA,Davies EA,Ferguson RM

    更新日期:1994-08-27 00:00:00

  • Prevention of premature ovarian failure and osteoporosis induced by irradiation using allogeneic ovarian/bone marrow transplantation.

    abstract:BACKGROUND:Two side effects of irradiation are premature ovarian failure (POF) and osteoporosis, both of which are concerns not only clinically, for patients, but also experimentally, for animals. We examine whether bone marrow transplantation (BMT) can correct the POF induced by radiation and also address whether allo...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/TP.0b013e3181ca86bb

    authors: Feng W,Cui Y,Zhan H,Shi M,Cui W,Guo K,Li Q,Song C,Zhang Y,Mori T,Gershwin ME,Abraham NG,Ikehara S

    更新日期:2010-02-27 00:00:00

  • Conversion to sirolimus and mycophenolate can attenuate the progression of bronchiolitis obliterans syndrome and improves renal function after lung transplantation.

    abstract:BACKGROUND:Bronchiolitis obliterans syndrome (BOS) is the major problem after lung and heart-lung transplantation (LTx/HLTx). Sirolimus (Sir) and Mycophenolate (MMF) showed a promising efficacy in the treatment of BOS in animal models. The first clinical experience in converting LTx/HLTx-recipients with BOS from calcin...

    journal_title:Transplantation

    pub_type: 临床试验,杂志文章

    doi:10.1097/01.tp.0000195781.02268.5e

    authors: Groetzner J,Wittwer T,Kaczmarek I,Ueberfuhr P,Strauch J,Nagib R,Meiser B,Franke U,Reichart B,Wahlers T

    更新日期:2006-02-15 00:00:00

  • Utility in Treating Kidney Failure in End-Stage Liver Disease With Simultaneous Liver-Kidney Transplantation.

    abstract:BACKGROUND:Simultaneous liver-kidney (SLK) transplantation plays an important role in treating kidney failure in patients with end-stage liver disease. It used 5% of deceased donor kidney transplanted in 2015. We evaluated the utility, defined as posttransplant kidney allograft lifespan, of this practice. METHODS:Usin...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/TP.0000000000001491

    authors: Cheng XS,Stedman MR,Chertow GM,Kim WR,Tan JC

    更新日期:2017-05-01 00:00:00

  • Thymectomy impairs but does not uniformly abrogate long-term acceptance of semi-identical liver allograft in inbred miniature Swine temporarily treated with FK506.

    abstract:BACKGROUND:Long-term acceptance of semi-identical orthotopic liver transplants (OLTs) in inbred swine is induced by a 12-day course of FK506. To study whether acceptance is attributable to central or peripheral immune mechanisms, the effect of complete thymectomy was determined. METHODS:Total thymectomy was performed ...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/01.tp.0000121762.47432.15

    authors: Uryuhara K,Ambiru S,Dehoux JP,Oike F,Talpe S,Gianello P

    更新日期:2004-04-27 00:00:00