Blood pressure and renal function after kidney donation from hypertensive living donors.


BACKGROUND:Rising numbers of patients reaching end-stage kidney disease intensify the demand for expansion of the living-kidney-donor pool. On the basis of low risk in white donors with essential hypertension, our transplant center undertook a structured program of accepting hypertensive donors if kidney function and urine protein were normal. This study reports outcomes of hypertensive donors 1 year after kidney donation. METHODS:We studied detailed measurements of blood pressure (oscillometric, hypertensive therapy nurse [RN], and ambulatory blood pressure monitoring [ABPM]), clinical, and renal characteristics (iothalamate glomerular filtration rate [GFR], urine protein, and microalbumin) in 148 living kidney donors before and 6 to 12 months after nephrectomy. Twenty-four were hypertensive (awake ABPM>135/85 mm Hg and clinic/RN BP>140/90 mm Hg) before donation. RESULTS:After 282 days, normotensive donors had no change in awake ABPM pressure (pre 121 +/- 1/75 +/- 2 vs. post 120 +/- 1/ 5 +/- 1 mm Hg), whereas BP in hypertensive donors fell with both nonpharmacologic and drug therapy (pre 142 +/- 3/85 +/- 2 to post 132 +/- 2/80 +/- 1 mm Hg, P<.01). Hypertensive donors were older (53.4 vs. 41.4 years, P<.001) and had lower GFR after kidney donation (61 +/- 2 vs. 68 +/- 1 mL/min/1.73m, P<.01). After correction for age, no independent BP effect was evident for predicting GFR either before or after nephrectomy. Urine protein and microalbumin did not change in either group after donor nephrectomy. CONCLUSIONS:Our results indicate that white subjects with moderate, essential hypertension and normal kidney function have no adverse effects regarding blood pressure, GFR, or urinary protein excretion during the first year after living kidney donation. Although further studies are essential to confirm long-term safety, these data suggest that selected hypertensive patients may be accepted for living kidney donation.






Textor SC,Taler SJ,Driscoll N,Larson TS,Gloor J,Griffin M,Cosio F,Schwab T,Prieto M,Nyberg S,Ishitani M,Stegall M




Has Abstract


2004-07-27 00:00:00














  • Long-term Outcomes of Living Kidney Donation.

    abstract:BACKGROUND:In an effort to improve outcomes associated with living kidney donation, the Kidney Diseases Improving Global Outcomes (KDIGO) assembled a Work Group to develop comprehensive guidelines addressing the evaluation and care of living kidney donors. We conducted this systematic review to inform guideline develop...


    pub_type: 杂志文章


    authors: Slinin Y,Brasure M,Eidman K,Bydash J,Maripuri S,Carlyle M,Ishani A,Wilt TJ

    更新日期:2016-06-01 00:00:00

  • Long-term Renal Function in Living Kidney Donors Who Had Histological Abnormalities at Donation.

    abstract:BACKGROUND:Recent evidence suggests that living kidney donors are at an increased risk of end-stage renal disease. However, predicting which donors will have renal dysfunction remains challenging, particularly among those with no clinical evidence of disease at the time of donation. Although renal biopsies are not rout...


    pub_type: 杂志文章


    authors: Fahmy LM,Massie AB,Muzaale AD,Bagnasco SM,Orandi BJ,Alejo JL,Boyarsky BJ,Anjum SK,Montgomery RA,Dagher NN,Segev DL

    更新日期:2016-06-01 00:00:00

  • Promoting Organ Donor Registries Through Public Education: What Is the Cost of Securing Organ Donors?

    abstract:BACKGROUND:Transplant medicine's impact on America's public health is seriously limited by acute shortage of transplantable organs. Consequently, the United Sates has witnessed considerable investment in the promotion of organ donor registries. Although there is no evidence to support that donor registry promotion alle...


    pub_type: 杂志文章


    authors: Razdan M,Smith KJ,Bryce CL,Degenholtz HB

    更新日期:2016-06-01 00:00:00

  • The impact of donor and recipient hepatitis B surface antigen status on liver disease and survival in renal transplant recipients.

    abstract::Ninety-eight renal transplant recipients who had been followed for 1-6.5 years (median 3.2 years) were reviewed to determine the effect of donor and recipient hepatitis B surface antigen status on the incidence of hepatitis and on patient survival. The cumulative risk of developing hepatitis posttransplant was signifi...


    pub_type: 杂志文章


    authors: Chan PC,Lok AS,Cheng IK,Chan MK

    更新日期:1992-01-01 00:00:00

  • Long-term improvement of deceased donor renal allograft survival since 1996: a single transplant center study.

    abstract:BACKGROUND:The rate of acute rejection (AR) has decreased significantly, but whether this is associated with improvement in long-term graft survival is controversial. METHODS:We analyzed 1445 consecutive adult deceased donor kidney transplant recipients from 1985 to 2005, over two periods (1985-1995 vs. 1996-2005) to ...


    pub_type: 杂志文章


    authors: Sola E,Gonzalez-Molina M,Cabello M,Burgos D,Ramos J,Gutierrez C,Lopez V,Soler J,de la Vega E,Hernandez D

    更新日期:2010-03-27 00:00:00

  • Treatment of graft-versus-host disease by extracorporeal photochemotherapy: a pilot study.

    abstract:BACKGROUND:Graft-versus-host disease (GVHD) is a major complication after bone marrow transplantation, which may be refractory to immunosuppressive drugs. As preliminary case reports suggested that extracorporeal photochemotherapy (ECP) using a Therakos device might be beneficial, we conducted a pilot study to assess t...


    pub_type: 杂志文章


    authors: Besnier DP,Chabannes D,Mahé B,Mussini JM,Baranger TA,Muller JY,Milpied N,Esnault VL

    更新日期:1997-07-15 00:00:00

  • The hepatic soluble guanylyl cyclase-cyclic guanosine monophosphate pathway mediates the protection of remote ischemic preconditioning on the microcirculation in liver ischemia-reperfusion injury.

    abstract:BACKGROUND:Remote ischemic preconditioning (RIPC) protects against liver ischemia reperfusion (IR) injury. An essential circulating mediator of this protection is nitric oxide (NO) induced by lower limb RIPC. One of the mechanisms through which NO generally acts is the soluble guanylyl cyclase-cyclic GMP (sGC-cGMP) pat...


    pub_type: 杂志文章


    authors: Abu-Amara M,Yang SY,Quaglia A,Rowley P,Tapuria N,Fuller B,Davidson B,Seifalian A

    更新日期:2012-05-15 00:00:00

  • The effect of verapamil on renal function after warm and cold ischemia in the isolated perfused rat kidney.

    abstract::The potential usefulness of verapamil, a calcium channel blocker to renal allograft preservation, was investigated using the isolated perfused rat kidney. Two models of ischemic injury were used. In the first model, rat kidneys were exposed to 40 min of 37 degrees C ischemia on the perfusion circuit. Addition of verap...


    pub_type: 杂志文章


    authors: Shapiro JI,Cheung C,Itabashi A,Chan L,Schrier RW

    更新日期:1985-12-01 00:00:00

  • Molecular Imaging of Acute Cardiac Transplant Rejection: Animal Experiments and Prospects.

    abstract::Acute rejection (AR) remains the biggest challenge during the first year after heart transplantation despite advances in immunosuppressive therapy. The early detection and curbing of AR are crucial to the survival of transplant recipients. However, as the criterion standard for AR, endomyocardial biopsy has several li...


    pub_type: 杂志文章,评审


    authors: Chen Y,Zhang L,Liu J,Zhang P,Chen X,Xie M

    更新日期:2017-09-01 00:00:00

  • Activation of the purine salvage pathway in mononuclear cells of cardiac recipients treated with mycophenolate mofetil.

    abstract:BACKGROUND:The objective of this study was to investigate purine nucleotide metabolism in peripheral blood mononuclear cells (PBMC) of cardiac transplant recipients switched from azathioprine to mycophenolate mofetil (MMF). METHODS:Concentrations of guanosine 5'triphosphate (GTP) and adenosine 5'triphosphate (ATP), th...


    pub_type: 临床试验,杂志文章


    authors: Devyatko E,Zuckermann A,Bohdjalian A,Roedler S,Dunkler D,Grimm M,Weigel G

    更新日期:2006-07-15 00:00:00

  • Human hepatic stellate cells inhibit T-cell response through B7-H1 pathway.

    abstract:BACKGROUND:The liver is an immunologic privileged organ; liver allografts are accepted across major histocompatibility complex barriers in many species. However, hepatocyte transplants are acutely rejected, suggesting a role for liver nonparenchymal cells in regulating the immunoresponse. We have shown potent immunoreg...


    pub_type: 杂志文章


    authors: Charles R,Chou HS,Wang L,Fung JJ,Lu L,Qian S

    更新日期:2013-07-15 00:00:00

  • Living donor liver transplantation and tolerance: a potential strategy in cholangiocarcinoma.

    abstract:BACKGROUND:Donor-specific immune tolerance has been reported in isolated cases of kidney transplantation associated with bone marrow transplantation. The following is a description of a living donor liver transplantation for a hilar cholangiocarcinoma in a previous recipient of an allogeneic bone marrow transplant. ME...


    pub_type: 杂志文章


    authors: Kadry Z,Mullhaupt B,Renner EL,Bauerfeind P,Schanz U,Pestalozzi BC,Studer G,Zinkernagel R,Clavien PA

    更新日期:2003-09-27 00:00:00

  • Regulatory T cells: potential in organ transplantation.

    abstract::Active regulation or suppression of donor reactive cells is emerging as a key mechanism for inducing and maintaining unresponsiveness to donor alloantigens. Accumulating evidence suggests that a balance between immunoregulation and deletion of donor alloantigen reactive T cells can provide effective control of immune ...


    pub_type: 杂志文章,评审


    authors: Wood KJ,Luo S,Akl A

    更新日期:2004-01-15 00:00:00

  • Time-dependent impairment of mitochondrial function after storage and transplantation of rabbit kidneys.

    abstract:BACKGROUND:The mitochondrial respiratory chain is implicated as a major target of kidney damage after ischemia-reperfusion. This study measures changes in integrated mitochondrial function and in the activity of enzymes of the respiratory chain after cold storage and transplantation-reperfusion in vivo. METHODS:Mitoch...


    pub_type: 杂志文章


    authors: Sammut IA,Burton K,Balogun E,Sarathchandra P,Brooks KJ,Bates TE,Green CJ

    更新日期:2000-04-15 00:00:00

  • Mapping and transcriptional properties of RT1 class II region genes.

    abstract::The class II region of major histocompatibility complex of the rat. Rattus norvegicus (RT1) consists of RT1.B, RT1.D, and RT1.H subregions. The gene order around the H subregion was determined as RT1.A--H beta-H alpha--B by RFLP analysis of naturally occurring intra-RT1 recombinant rats with HLA DP probes. A unique re...


    pub_type: 杂志文章


    authors: Fujii H,Kakinuma M,Yoshiki T,Natori T

    更新日期:1991-08-01 00:00:00

  • Frequency of kidney rejection in diabetic patients undergoing simultaneous kidney and pancreatic islet cell transplantation.

    abstract::An increased frequency of kidney rejection has been reported in diabetic patients who have simultaneous pancreas and kidney transplantation compared with patients who have a kidney transplant alone. Kidney graft outcome is similar in the two groups. The mechanism for increased kidney graft rejection with a simultaneou...


    pub_type: 杂志文章


    authors: Carroll PB,Ricordi C,Shapiro R,Rilo HR,Fontes P,Scantlebury V,Irish W,Tzakis AG,Starzl TE

    更新日期:1993-04-01 00:00:00

  • Donor bone marrow potentiates the effect of tacrolimus on nonvascularized heart allograft survival: association with microchimerism and growth of donor dendritic cell progenitors from recipient bone marrow.

    abstract:BACKGROUND:The influence of donor hematopoietic cell microchimerism on organ allograft survival has been studied largely in vascularized transplant models. Here, we examine the impact of donor bone marrow (BM) cells administered intravenously together with transient systemic tacrolimus therapy on microchimerism, the su...


    pub_type: 杂志文章


    authors: Khanna A,Steptoe RJ,Antonysamy MA,Li W,Thomson AW

    更新日期:1998-02-27 00:00:00

  • Long-term metabolic control of autoimmune diabetes in spontaneously diabetic nonobese diabetic mice by nonvascularized microencapsulated adult porcine islets.

    abstract:BACKGROUND:The long-term metabolic function of microencapsulated xenogeneic adult porcine islets (API) was assessed in a murine model of type 1 diabetes mellitus. METHODS:API were encapsulated in barium-gelled alginate and transplanted intraperitoneally in diabetic nonobese diabetic (NOD) mice given no immunosuppressi...


    pub_type: 杂志文章


    authors: Cui H,Tucker-Burden C,Cauffiel SM,Barry AK,Iwakoshi NN,Weber CJ,Safley SA

    更新日期:2009-07-27 00:00:00

  • Treatment of patients with recurrent hepatitis C after liver transplantation with peginterferon alfa-2B plus ribavirin.

    abstract:BACKGROUND:Recurrent hepatitis C virus (HCV) after liver transplantation (OLT) is a major cause of graft loss in HCV-positive patients. In this study, we evaluated the efficacy and safety of pegylated interferon alfa-2b (peginterferon) and ribavirin treatment for recurrent HCV after OLT and analyzed the influence of an...


    pub_type: 临床试验,杂志文章


    authors: Neumann U,Puhl G,Bahra M,Berg T,Langrehr JM,Neuhaus R,Neuhaus P

    更新日期:2006-07-15 00:00:00

  • Separate clones of cytotoxic T lymphocytes are generated against private and public H-2 antigens.

    abstract::By cytolysis and monolayer absorption tests, the kinetics of the generation of CBA/H cytotoxic lymphocytes (Tc) in response to stimulation by H-2b antigens have been analyzed in vitro. The Tc population which reacts with public antigens of H-2b and H-2d strains shows peak activity in culture at 4 to 5 days, then rapi...


    pub_type: 杂志文章


    authors: Schnagl HY,Boyle W

    更新日期:1980-06-01 00:00:00

  • Local cellular immunity in the draining lymph nodes of mice after immunization with histocompatibility alloantigens.

    abstract::Mice immunized with allogeneic cells exhibit a local component of cellular immunity that is confined to lymph nodes draining the site of immunization. After immunization of C3H mice by skin grafting or by i.p. or footpad injection of F1 hybrid spleen cells, draining lymph nodes show increased responsiveness toward the...


    pub_type: 杂志文章


    authors: Snow C,Hilgard HR

    更新日期:1981-07-01 00:00:00

  • Predictors of graft survival in pediatric living-related kidney transplant recipients.

    abstract:BACKGROUND:A successful kidney transplant from a living-related donor (LRD) remains the most effective renal replacement therapy for children with end-stage renal failure. The use of LRD kidneys results in decreased time on dialysis, increased graft survival, and better function compared with kidneys transplanted from ...


    pub_type: 杂志文章


    authors: Ishitani M,Isaacs R,Norwood V,Nock S,Lobo P

    更新日期:2000-07-27 00:00:00

  • Mechanisms of acquired thymic unresponsiveness to renal allografts. Thymic recognition of immunodominant allo-MHC peptides induces peripheral T cell anergy.

    abstract::We have recently shown that a single intrathymic injection of synthetic 25mer peptides, representing full sequences of the hypervariable domain of RT1.BuB (4 peptides) and RT1.Du beta (4 peptides) WF class II MHC molecules, 48 hr before transplantation induces donor-specific unresponsiveness to WF rat renal allografts...


    pub_type: 杂志文章


    authors: Sayegh MH,Perico N,Gallon L,Imberti O,Hancock WW,Remuzzi G,Carpenter CB

    更新日期:1994-07-27 00:00:00

  • Detection of cardiac allograft rejection and myocyte necrosis by monoclonal antibody to cardiac myosin.

    abstract::Indium 111-labeled monoclonal antibody to cardiac myosin was examined for efficacy in the detection of cardiac graft rejection and rejection-related myocyte necrosis. Heterotopic heart transplants were performed in isogenic and allogenic groups of rats (n = 56). At selected intervals posttransplant, uptake of injected...


    pub_type: 杂志文章


    authors: Allen MD,Tsuboi H,Togo T,Eary JF,Gordon D,Thomas R,Reichenbach DD

    更新日期:1989-12-01 00:00:00

  • A prospective randomized trial comparing sequential ganciclovir-high dose acyclovir to high dose acyclovir for prevention of cytomegalovirus disease in adult liver transplant recipients.

    abstract::Cytomegalovirus disease is an important cause of morbidity following liver transplantation. To date there has not been an effective prophylaxis for CMV disease after liver transplantation. One hundred forty-three patients were randomized to receive either high dose oral acyclovir (800 mg 4 times a day) alone for 3 mon...


    pub_type: 临床试验,杂志文章,随机对照试验


    authors: Martin M,Mañez R,Linden P,Estores D,Torre-Cisneros J,Kusne S,Ondick L,Ptachcinski R,Irish W,Kisor D

    更新日期:1994-10-15 00:00:00

  • Prevention of late renal changes after initial ischemia/reperfusion injury by blocking early selectin binding.

    abstract:BACKGROUND:Increasing clinical evidence suggests that delayed initial function secondary to ischemia/reperfusion injury alone, and particularly in combination with early episodes of acute rejection, reduces kidney allograft survival over time. METHODS:We investigated changes developing over the long term following a s...


    pub_type: 杂志文章


    authors: Takada M,Nadeau KC,Shaw GD,Tilney NL

    更新日期:1997-12-15 00:00:00

  • Immunosuppression with a combination of the leflunomide analog, FK778, and microemulsified cyclosporine for renal transplantation in mongrel dogs.

    abstract:BACKGROUND:The leflunomide analog, FK778, is a selective pyrimidine synthesis inhibitor. In rodent models, FK778 is efficacious in the prevention of allograft and xenograft rejection, and a combination of FK778 and cyclosporine has synergistic immunosuppressive efficacy. METHODS:Heterotopic renal transplantation was p...


    pub_type: 杂志文章


    authors: Kyles AE,Gregory CR,Griffey SM,Bernsteen L,Pierce J,Lilja HS,Morris RE

    更新日期:2003-04-27 00:00:00

  • De novo sirolimus-based immunosuppression after liver transplantation for hepatocellular carcinoma: long-term outcomes and side effects.

    abstract:BACKGROUND:We report long-term outcomes and side effects after transplantation for hepatocellular carcinoma (HCC) using de novo, sirolimus-based immunosuppression (IS). METHODS:A total of 70 patients with HCC (mean age: 54.4+/-7 years, female/male: 12/58) were transplanted and included in the study. Immunosuppression ...


    pub_type: 杂志文章


    authors: Toso C,Meeberg GA,Bigam DL,Oberholzer J,Shapiro AM,Gutfreund K,Ma MM,Mason AL,Wong WW,Bain VG,Kneteman NM

    更新日期:2007-05-15 00:00:00

  • Notch Signaling and Alloreactivity.

    abstract::Solid organ and allogeneic hematopoietic cell transplantation have become standard therapeutic interventions that save patient lives and improve quality of life. Our enhanced understanding of transplantation immunobiology has refined clinical management and improved outcomes. However, organ rejection and graft-versus-...


    pub_type: 杂志文章,评审


    authors: Radojcic V,Maillard I

    更新日期:2016-12-01 00:00:00

  • Progression of renal dysfunction in cardiac transplantation after the introduction of everolimus in the immunosuppressive regime.

    abstract::The aim of this study was to analyze, in heart transplant patients, if renal function improvement after cyclosporine replacement by everolimus persists at the middle term and its predictors. We studied prospectively 56 patients in whom conversion was consecutively made. Forty-five patients completed the follow-up peri...


    pub_type: 杂志文章


    authors: Moro López JA,Almenar L,Martínez-Dolz L,Sánchez-Lázaro I,Agüero J,Buendía F,Ortiz V,Salvador A

    更新日期:2009-02-27 00:00:00