Increased rejection in living unrelated versus living related kidney transplants does not affect short-term function and survival.

Abstract:

BACKGROUND:At our institution, increased kidney donation from unrelated donors accounts for a steady rise in live donor kidney transplantation rates. We compared outcomes of living related (LRT) versus living unrelated kidney transplants (LURT) and analyzed the effect of early rejection upon graft survival. METHODS:A retrospective analysis on 428 adult living donor kidney transplants was performed. Graft function and survival were compared between LRT and LURT and risk factors for 1-year rejection were defined by multivariate analysis. RESULTS:Between 1/1/97 and 12/31/01, 308 LRT and 120 LURT were performed at the University of California San Francisco. Donor age and number of mismatches were significantly higher in the LURT group. Patient and graft survival were similar in both groups. After a median follow-up of 26 months, graft survival was 94.8% (LRT) versus 93.3% (LURT). Five-year serum creatinine levels were comparable in both populations. One-year rejection was higher in the LURT group (30% vs. 18.5%; P<0.01). Rejection was influenced by the number of human leukocyte antigen mismatches. Other independent risk factors for early rejection were poor initial graft function, donor age greater than 55 years, and recipient body mass index greater than 30. Patients with poor initial graft function and early rejection had a statistically greater incidence of subtherapeutic tacrolimus trough levels on postoperative day 7. CONCLUSIONS:Despite a higher incidence of early rejection, LURT show similar function and survival compared with LRT. In high-risk patients receiving living unrelated renal transplants, consideration should be given to intensify initial immunosuppression to prevent early rejection episodes.

journal_name

Transplantation

journal_title

Transplantation

authors

Fuller TF,Feng S,Brennan TV,Tomlanovich S,Bostrom A,Freise CE

doi

10.1097/01.tp.0000135464.11616.5a

subject

Has Abstract

pub_date

2004-10-15 00:00:00

pages

1030-5

issue

7

eissn

0041-1337

issn

1534-6080

pii

00007890-200410150-00013

journal_volume

78

pub_type

杂志文章
  • Long-term renal allograft survival: prognostic implication of the timing of acute rejection episodes.

    abstract:BACKGROUND:The timing of an acute rejection may have a variable impact on renal allograft survival. To determine whether the time of first acute transplant rejection (ATR) is an independent predictor of long-term allograft survival, we studied 31,600 first cadaveric renal transplants that were functional on the first t...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/00007890-199705150-00013

    authors: Leggat JE Jr,Ojo AO,Leichtman AB,Port FK,Wolfe RA,Turenne MN,Held PJ

    更新日期:1997-05-15 00:00:00

  • Rapamycin Prolongs Graft Survival and Induces CD4+IFN-γ+IL-10+ Regulatory Type 1 Cells in Old Recipient Mice.

    abstract:BACKGROUND:Although the elderly represents a rapidly growing population among transplant recipients, age-specific aspects have not been considered sufficiently in clinical trials. Moreover, age-specific effects of immunosuppressive therapies remain poorly understood. METHODS:Here, we assessed the impact of rapamycin o...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/TP.0000000000001902

    authors: Quante M,Heinbokel T,Edtinger K,Minami K,Uehara H,Nian Y,Azuma H,Abdi R,Elkhal A,Tullius SG

    更新日期:2018-01-01 00:00:00

  • Comparative long-term evaluation of tacrolimus and cyclosporine in pediatric liver transplantation.

    abstract:BACKGROUND:In this report, we compare the long-term outcome of pediatric liver transplantation (LTx) patients maintained with tacrolimus-based and with cyclosporine (CsA)-based immunosuppressive therapy. We examine long-term patient and graft survival, the incidence of rejection, and immunosuppression-related complicat...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/00007890-200008270-00015

    authors: Jain A,Mazariegos G,Kashyap R,Green M,Gronsky C,Starzl TE,Fung J,Reyes J

    更新日期:2000-08-27 00:00:00

  • LPS-induced Airway-centered Inflammation Leading to BOS-like Airway Remodeling Distinct From RAS-like Fibrosis in Rat Lung Transplantation.

    abstract:BACKGROUND:Localization of inflammatory stimuli may direct lung allografts to different phenotypes of chronic dysfunction, such as bronchiolitis obliterans syndrome (BOS) or restrictive allograft syndrome (RAS). We hypothesized that airway stimulation with lipopolysaccharide (LPS) in rats leads to airway-centered infla...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/TP.0000000000003097

    authors: Takahagi A,Sato M,Chen-Yoshikawa TF,Miyamoto E,Saito M,Gochi F,Hamaji M,Yoshizawa A,Terasaki Y,Urushiyama H,Aoyama A,Sonobe M,Date H

    更新日期:2020-06-01 00:00:00

  • Tacrolimus (FK506) and cyclosporine reduce the uptake and transport of particles into rabbit Peyer's patches.

    abstract::Tacrolimus (FK) and cyclosporine (Cs) are potent immunosuppressants that effectively prevent the rejection of transplanted organs including liver and small intestine. Our study examined the effects of these immunosuppressants on Peyer's patches, which play an important role in mucosal immune response through uptake an...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/00007890-200204150-00006

    authors: Fujimura Y,Owen RL

    更新日期:2002-04-15 00:00:00

  • Factors influencing the patterns of T lymphocyte allorecognition.

    abstract:BACKGROUND:Strong alloreactive T cell responses are a menace in transplantation surgery and their menagement requires understanding the basis of alloreactivity. Alloantigen recognition can be peptide independent, peptide specific, or peptide dependent. The mechanisms influencing each recognition pattern are largely unk...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/00007890-200203150-00024

    authors: Nesić D,Marić M,Santori FR,Vukmanović S

    更新日期:2002-03-15 00:00:00

  • Impact of Acuity Circles on Outcomes for Pediatric Liver Transplant Candidates.

    abstract:BACKGROUND:In December 2018, United Network for Organ Sharing approved an allocation scheme based on recipients' geographic distance from a deceased donor (acuity circles [ACs]). Previous analyses suggested that ACs would reduce waitlist mortality overall, but their impact on pediatric subgroups was not considered. ME...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/TP.0000000000003079

    authors: Mogul DB,Perito ER,Wood N,Mazariegos GV,VanDerwerken D,Ibrahim SH,Mohammad S,Valentino PL,Gentry S,Hsu E

    更新日期:2020-08-01 00:00:00

  • Evidence that the immunosuppressive effects of FK506 and cyclosporine are identical.

    abstract::The fungal metabolite FK506 was discovered because it shared an important property, the ability to inhibit production of IL-2, with another well-known immunosuppressive fungal metabolite, CsA. FK506 has, since its isolation, also been shown to share other immunosuppressive effects with CsA. This study was performed to...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/00007890-199012000-00021

    authors: Johansson A,Möller E

    更新日期:1990-12-01 00:00:00

  • Islet Transplantation Provides Superior Glycemic Control With Less Hypoglycemia Compared With Continuous Subcutaneous Insulin Infusion or Multiple Daily Insulin Injections.

    abstract:BACKGROUND:The aim was to compare efficacy of multiple daily injections (MDI), continuous subcutaneous insulin infusion (CSII) and islet transplantation to reduce hypoglycemia and glycemic variability in type 1 diabetes subjects with severe hypoglycemia. METHODS:This was a within-subject, paired comparison of MDI and ...

    journal_title:Transplantation

    pub_type: 杂志文章,多中心研究

    doi:10.1097/TP.0000000000001381

    authors: Holmes-Walker DJ,Gunton JE,Hawthorne W,Payk M,Anderson P,Donath S,Loudovaris T,Ward GM,Kay TW,OʼConnell PJ

    更新日期:2017-06-01 00:00:00

  • Marked mitigation of transplant vascular sclerosis in FasLgld (CD95L) mutant recipients. The role of alloantibodies in the development of chronic rejection.

    abstract:BACKGROUND:In the acute rejection of allografts, the interaction between Fas (CD95) and its ligand (FasL; CD95L) has been shown to be involved in mediating apoptotic cell death. The role, however, of these molecules in the pathogenesis of transplant vascular sclerosis is as yet undetermined. The present study was there...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/00007890-199905270-00001

    authors: Subbotin V,Sun H,Aitouche A,Salam A,Valdivia LA,Fung JJ,Starzl TE,Rao AS

    更新日期:1999-05-27 00:00:00

  • Report of the Key Opinion Leaders Meeting on Stem Cell-derived Beta Cells.

    abstract::Beta cell replacement has the potential to restore euglycemia in patients with insulin-dependent diabetes. Although great progress has been made in establishing allogeneic islet transplantation from deceased donors as the standard of care for those with the most labile diabetes, it is also clear that the deceased dono...

    journal_title:Transplantation

    pub_type: 杂志文章,评审

    doi:10.1097/TP.0000000000002217

    authors: Odorico J,Markmann J,Melton D,Greenstein J,Hwa A,Nostro C,Rezania A,Oberholzer J,Pipeleers D,Yang L,Cowan C,Huangfu D,Egli D,Ben-David U,Vallier L,Grey ST,Tang Q,Roep B,Ricordi C,Naji A,Orlando G,Anderson DG,P

    更新日期:2018-08-01 00:00:00

  • Extracorporeal photopheresis after lung transplantation: a 10-year single-center experience.

    abstract::We report the largest single-center experience with extracorporeal photopheresis (ECP) for bronchiolitis obliterans syndrome (BOS) and recurrent acute rejection (AR) after lung transplantation. Lung transplant recipients undergoing ECP for BOS and recurrent AR were included (1997-2007). The rate of forced expiratory v...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/TP.0b013e31818bc024

    authors: Benden C,Speich R,Hofbauer GF,Irani S,Eich-Wanger C,Russi EW,Weder W,Boehler A

    更新日期:2008-12-15 00:00:00

  • Evidence that specific cellular immunity cannot account for death of Mus caroli embryos transferred to Mus musculus with severe combined immune deficiency disease.

    abstract::Mus caroli blastocysts transferred to pseudopregnant Mus musculus implant but die about midgestation. Death of the M caroli embryos is associated with infiltration of the fetoplacental units by M musculus lymphocytes, including functional cytotoxic T lymphocytes (CTL). To determine if specific maternal antifetal immun...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/00007890-198806000-00021

    authors: Crepeau MA,Croy BA

    更新日期:1988-06-01 00:00:00

  • Differentiation of class I- and class II-directed donor-specific alloreactivity in bronchoalveolar lavage lymphocytes from lung transplant recipients.

    abstract::Previous studies have demonstrated that donor antigen-specific primed-lymphocyte-test (PLT) reactivity of bronchoalveolar lavage lymphocytes is strongly associated with acute pulmonary rejection and with obliterative bronchiolitis (OB); however, a systematic analysis of PLT reactivity as being class I-or II-directed h...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/00007890-199201000-00036

    authors: Reinsmoen NL,Bolman RM,Savik K,Butters K,Hertz M

    更新日期:1992-01-01 00:00:00

  • Influence of HLA matching on rejections and short- and long-term primary cadaveric allograft survival.

    abstract::Distribution of cadaveric donor kidneys, based upon the donor-recipient HLA match grade, remains one of the major controversies in transplantation. To determine whether matching results in fewer rejection episodes and better graft survival, we retrospectively studied our single-center patient population of 683 cyclosp...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/00007890-199311000-00037

    authors: Kerman RH,Kimball PM,Lindholm A,Van Buren CT,Katz SM,Lewis RM,McClain J,Podbielski J,Williams J,Kahan BD

    更新日期:1993-11-01 00:00:00

  • A dual mechanism of immunosuppression by FK-506. Differential suppression of IL-4 and IL-10 levels in T helper 2 cells.

    abstract::FK-506 is known to suppress the transcription of several genes encoding cytokines (e.g., IL-2, IFN-gamma) thought to play an important role in the allograft response. This general inhibition of cytokine gene transcription and protein production was previously thought to be the main mechanism by which FK-506 suppressed...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/00007890-199310000-00038

    authors: Wang SC,Morel PA,Wang Q,Jordan ML,Simmons RL,Tweardy DJ

    更新日期:1993-10-01 00:00:00

  • Porcine model of auxiliary partial orthotopic liver transplantation for acute liver failure.

    abstract:BACKGROUND:Auxiliary partial orthotopic liver transplantation (APOLT) has been an effective alternative in acute liver failure (ALF), but clinically several problems remain to be resolved. Thus, we attempt to establish an APOLT model for ALF using a large animal and demonstrate the validity of our model. METHODS:In ex...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/01.tp.0000243360.64554.fa

    authors: Fukueda M,Ishizaki N,Hamada N,Kadono J,Kaieda M,Nakamura N,Komokata T,Sakata R

    更新日期:2006-11-27 00:00:00

  • Evaluation of renal function in potential living kidney donors.

    abstract:BACKGROUND:Most transplant centers in the United States, including our own, use creatinine clearance (Ccr) to estimate glomerular filtration rate (GFR) in potential living kidney donors. The purpose of this study was to evaluate our experience with estimation of donor GFR by Ccr and to explore other potential strategie...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/00007890-200101270-00016

    authors: Bertolatus JA,Goddard L

    更新日期:2001-01-27 00:00:00

  • The diagnosis of CMV pneumonitis in lung and heart/lung transplant patients by PCR compared with traditional laboratory criteria.

    abstract::Polymerase chain reaction (PCR) amplification of CMV DNA recovered from bronchial alveolar lavage (BAL) and peripheral blood samples was compared with tissue culture, cytology, and/or histology for the earlier detection of CMV pneumonitis in 12 recipients of single-lung or heart/lung transplants. In patients with conf...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/00007890-199308000-00017

    authors: Buffone GJ,Frost A,Samo T,Demmler GJ,Cagle PT,Lawrence EC

    更新日期:1993-08-01 00:00:00

  • Comparison of pulsatile perfusion and cold storage for paired kidney allografts.

    abstract::Use of pulsatile perfusion to optimize outcomes in deceased donor kidney transplantation remains controversial. This study is a retrospective analysis of all cadaveric renal allografts procured locally by our center over a 3-year period. Kidney pairs were identified in which one kidney underwent pulsatile perfusion an...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/TP.0b013e318187b978

    authors: Shah AP,Milgrom DP,Mangus RS,Powelson JA,Goggins WC,Milgrom ML

    更新日期:2008-10-15 00:00:00

  • Graft-protective role of high pretransplantation IgA-anti-Fab autoantibodies: confirmatory evidence obtained in more than 4000 kidney transplants. The Collaborative Transplant Study.

    abstract:BACKGROUND:Preliminary studies showed an excellent success rate of kidney grafts in patients with high pretransplantation serum levels of IgA autoantibodies directed against the Fab region of the human IgG molecule. METHODS:With the collaboration of 30 centers from around the world, we attempted to verify the role of ...

    journal_title:Transplantation

    pub_type: 评论,杂志文章,多中心研究

    doi:10.1097/00007890-200004150-00021

    authors: Süsal C,Döhler B,Opelz G

    更新日期:2000-04-15 00:00:00

  • HLA matching and the United Network for Organ Sharing Allocation System: impact of HLA matching on African-American recipients of cadaveric kidney transplants.

    abstract:BACKGROUND:A recent proposal supports the elimination of allocation points for human leukocyte antigen (HLA) mismatches (MM) in cadaveric kidney transplantation. The intent is to increase access for some racial groups that might be disadvantaged by the representation of race-specific HLA in a largely white donor pool. ...

    journal_title:Transplantation

    pub_type: 评论,杂志文章

    doi:10.1097/00007890-200212150-00024

    authors: Rebellato LM,Arnold AN,Bozik KM,Haisch CE

    更新日期:2002-12-15 00:00:00

  • Deficient TNF-alpha and IFN-gamma production correlates with nondetectable donor-specific cytotoxicity after clinical kidney transplantation.

    abstract:BACKGROUND:We previously reported that no cytotoxic T-lymphocyte precursor frequencies (CTLpf) were found in 60% of patients on azathioprine or mycophenolate mofetil+Pred long after kidney transplantation. We questioned whether the absence of donor-specific CTLpf was associated with low levels of stimulatory Th1 (tumor...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/TP.0b013e3181a36c85

    authors: van Besouw NM,de Kuiper R,van der Mast BJ,van de Wetering J,Baan CC,Weimar W

    更新日期:2009-05-27 00:00:00

  • The mechanism of synergistic interaction between anti-interleukin 2 receptor monoclonal antibody and cyclosporine therapy in rat recipients of organ allografts.

    abstract::Untreated anephric LEW rats die ca. 9 days following transplantation of LBNF1 kidney allografts. Although treatment with ART-18, a mouse antirat IL-2R mAb (300 micrograms/kg/day x 10 days), prolonged graft survival to ca. 3 weeks, the severely impaired renal function was comparable to untreated controls (creatinine le...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/00007890-199010000-00002

    authors: Ueda H,Hancock WW,Cheung YC,Diamantstein T,Tilney NL,Kupiec-Weglinski JW

    更新日期:1990-10-01 00:00:00

  • Comparison of Preemptive Therapy and Antiviral Prophylaxis for Prevention of Cytomegalovirus in Seropositive Liver Transplant Recipients.

    abstract:BACKGROUND:Few studies have directly compared preemptive therapy (PET) and antiviral prophylaxis (AP) for prevention of cytomegalovirus (CMV) disease in CMV seropositive (R+) orthotopic liver transplant (OLT) recipients. METHODS:We prospectively assessed CMV disease and clinical outcomes among 160 consecutive R+ OLT r...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/TP.0000000000002029

    authors: Liu AW,Jutivorakool K,Fisher CE,Rakita RM,Reyes JD,Bhattacharya RB,Jerome KR,Limaye AP

    更新日期:2018-04-01 00:00:00

  • A Practical Guide to the Clinical Implementation of Biomarkers for Subclinical Rejection Following Kidney Transplantation.

    abstract::Noninvasive biomarkers are needed to monitor stable patients following kidney transplantation (KT), as subclinical rejection, currently detectable only with invasive surveillance biopsies, can lead to chronic rejection and graft loss. Several biomarkers have recently been developed to detect rejection in KT recipients...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/TP.0000000000003064

    authors: Naesens M,Friedewald J,Mas V,Kaplan B,Abecassis MM

    更新日期:2020-04-01 00:00:00

  • Molecular evidence of injury and inflammation in normal and fibrotic renal allografts one year posttransplant.

    abstract:INTRODUCTION:Factors contributing to kidney transplant fibrosis remain incompletely understood, particularly in the absence of acute complications. METHODS:Baseline and 1-year surveillance biopsies from 15 uncomplicated living donor kidney transplants were subjected to microarray and quantitative reverse transcription...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/01.tp.0000265501.33362.d3

    authors: Park W,Griffin M,Grande JP,Cosio F,Stegall MD

    更新日期:2007-06-15 00:00:00

  • Impact of renal posttransplantation amputation on allograft outcomes: a study of United States renal data system.

    abstract:BACKGROUND:The prevalence of renal posttransplantation amputation and its impact on allograft and patient survival have not been widely reported. METHODS:We used an incident cohort of patients who underwent renal transplantation between June 2004 and September 2009. Amputation data were obtained using Medicare institu...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/TP.0b013e31828e72b4

    authors: Brar A,Jindal RM,Sumrani N,John D,Mondal Z,Tedla F,Salifu MO

    更新日期:2013-05-27 00:00:00

  • Adult living-donor liver transplantation with ABO-incompatible grafts.

    abstract:BACKGROUND:Liver transplantation using ABO-incompatible grafts is rarely performed because the reported outcome is poorer than with compatible grafts. We report our positive experience with adult-to-adult living-donor liver transplant (LDLT) using ABO-incompatible grafts. METHODS:The immunosuppressive protocol consist...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/TP.0b013e3181665172

    authors: Testa G,Vidanovic V,Chejfec G,Gangemi A,Iqpal R,Porubsky M,Pham T,Benedetti E

    更新日期:2008-03-15 00:00:00

  • Seasonal variation in outpatient blood pressure in stable renal transplant recipients.

    abstract::Seasonal variation in blood pressure (BP) has been described in the general and dialysis populations, with higher recordings noted in the winter than in the summer. This difference has been attributed to changes in weight, ambient temperature, and length of daylight. In this study, we sought to determine whether such ...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/00007890-200112150-00014

    authors: Prasad GV,Nash MM,Zaltzman JS

    更新日期:2001-12-15 00:00:00