Preoperative factors associated with outcome and their impact on resource use in 1148 consecutive primary liver transplants.

Abstract:

BACKGROUND:Hepatic transplantation is a highly effective but costly treatment for end-stage hepatic dysfunction. One approach to improve efficiency in the use of scarce organs for transplantation is to identify preoperative factors that are associated with poor outcome posttransplantation. This may assist both in selecting patients optimal for transplantation and in identifying strategies to improve survival. METHODS:In the present work, we retrospectively reviewed consecutive liver transplants performed at the University of California at Los Angeles during a 6-year period and determined preoperative variables that were associated with outcome in primary grafts. In addition, we used the hospital's cost accounting database to determine the impact of these variables on the degree of resource use by high-risk patients. RESULTS:We found five variables to have independent prognostic value in predicting graft survival after primary liver transplantation: (1) donor age, (2) recipient age, (3) donor sodium, (4) recipient creatinine, and (5) recipient ventilator requirement pretransplant. Recipient ventilator requirement and elevated creatinine were associated with significant increases in resource use during the transplant admission. CONCLUSIONS:Patients at high risk for graft failure and costly transplants can be identified preoperatively by a set of parameters that are readily available, noninvasive, and inexpensive. Selection of recipients on the basis of these data would improve the efficiency of liver transplantation and reduce its cost.

journal_name

Transplantation

journal_title

Transplantation

authors

Markmann JF,Markmann JW,Markmann DA,Bacquerizo A,Singer J,Holt CD,Gornbein J,Yersiz H,Morrissey M,Lerner SM,McDiarmid SV,Busuttil RW

doi

10.1097/00007890-200109270-00023

subject

Has Abstract

pub_date

2001-09-27 00:00:00

pages

1113-22

issue

6

eissn

0041-1337

issn

1534-6080

journal_volume

72

pub_type

杂志文章
  • Assessing the efficacy of kidney paired donation--performance of an integrated three-site program.

    abstract:BACKGROUND:Kidney paired donation (KPD) has emerged as a viable option for renal transplant candidates with incompatible living donors. The aim of this study was to assess the "performance" of a three-site KPD program that allowed screening of multiple donors per recipient. METHODS:We reviewed retrospectively the acti...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/TP.0000000000000054

    authors: Li H,Stegall MD,Dean PG,Casey ET,Reddy KS,Khamash HA,Heilman RL,Mai ML,Taner CB,Kosberg CL,Bakken LL,Wozniak EJ,Giles KL,Veal LA,Gandhi MJ,Cosio FG,Prieto M

    更新日期:2014-08-15 00:00:00

  • Hepatic stellate cells preferentially expand allogeneic CD4+ CD25+ FoxP3+ regulatory T cells in an IL-2-dependent manner.

    abstract:BACKGROUND:Organ transplantation has been successfully practiced for decades, but the outcome of cell transplantation remains disappointing. This is the case in animal models; liver allografts in mice are spontaneously accepted without requirement of immunosuppression, whereas hepatocyte transplants in the same combina...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/TP.0b013e31818bfd13

    authors: Jiang G,Yang HR,Wang L,Wildey GM,Fung J,Qian S,Lu L

    更新日期:2008-12-15 00:00:00

  • Is the transjugular intrahepatic portocaval shunt procedure beneficial for liver transplant recipients?

    abstract::Recent reports document the efficacy of transjugular intrahepatic portocaval shunts (TIPS) for the prevention of portal hypertensive bleeding and have advocated its use as a bridge to liver transplantation. There are no reports, however, analyzing liver transplant results for patients with indwelling TIPS. We reviewed...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:

    authors: Freeman RB Jr,FitzMaurice SE,Greenfield AE,Halin N,Haug CE,Rohrer RJ

    更新日期:1994-08-15 00:00:00

  • The alloantigen-specific immunosuppressive activity of estradiol-chlorambucil conjugate (KM2210) and its beneficial effect on allogeneic bone marrow transplantation in mice.

    abstract::KM2210, a conjugate of estradiol and chlorambucil (CBL), which was originally developed as an anti-breast cancer agent, inhibits proliferative response of human mononuclear cells to alloantigens in mixed lymphocyte culture in a dose-dependent manner, but has no effect on their response to phytohemagglutinin. Neither e...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/00007890-199210000-00022

    authors: Matsudaira T,Kodo H,Okamoto S,Tani K,Tojo A,Ozawa K,Asano K,Asano S

    更新日期:1992-10-01 00:00:00

  • Acute rejection after renal transplantation is reduced by approximately 50% by prior therapeutic blood transfusions, even in tacrolimus-treated patients.

    abstract:BACKGROUND:The authors investigated the relationship between therapeutic blood transfusion before renal transplantation and rejection rates in cyclosporine- and tacrolimus-treated patients. METHODS:In one center, 265 consecutive recipients were studied. Protocol induction was with azathioprine, prednisolone, and cyclo...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/01.TP.0000111756.83834.A7

    authors: Higgins RM,Raymond NT,Krishnan NS,Veerasamy M,Rahmati M,Lam FT,Kashi H,West N

    更新日期:2004-02-15 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

  • Cardiac transplantation using extended-donor criteria organs for systemic amyloidosis complicated by heart failure.

    abstract:BACKGROUND:Systemic amyloidosis complicated by heart failure is associated with high cardiovascular morbidity and mortality. Heart transplantation for patients with systemic amyloidosis is controversial due to recurrence of disease in the transplanted organ or progression of disease in other organs. METHODS:All patien...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/01.tp.0000255567.80203.bd

    authors: Maurer MS,Raina A,Hesdorffer C,Bijou R,Colombo P,Deng M,Drusin R,Haythe J,Horn E,Lee SH,Marboe C,Naka Y,Schulman L,Scully B,Shapiro P,Prager K,Radhakrishnan J,Restaino S,Mancini D

    更新日期:2007-03-15 00:00:00

  • Inhibition of endothelin-converting enzyme attenuates transplant vasculopathy and rejection in rat cardiac allografts.

    abstract:BACKGROUND:Transplant vasculopathy in kidney and heart allografts is associated with marked elevation of endothelin-1 (ET-1), but a role for ET-1 in the pathogenesis of transplant vasculopathy and chronic rejection has not been established. We, therefore, tested whether inhibition of ET-1-converting enzyme by phosphora...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/00007890-199906270-00007

    authors: Simonson MS,Herman WH,Robinson A,Schulak J,Hricik DE

    更新日期:1999-06-27 00:00:00

  • Cytomegalovirus antibody status and renal transplantation: 1987-1994.

    abstract::We examined graft and patient survival rates of 47,146 patients in the United Network for Organ Sharing registry following transplants between donors and recipients who were cytomegalovirus (CMV) antibody negative and positive. CMV positivity increased with age to about 80% in patients over 60. Seropositivity was seen...

    journal_title:Transplantation

    pub_type: 杂志文章,多中心研究

    doi:10.1097/00007890-199607150-00007

    authors: Hirata M,Terasaki PI,Cho YW

    更新日期:1996-07-15 00:00:00

  • Bone marrow transplantation following total lymphoid irradiation. I. Correlation with field size and suppressor cell induction.

    abstract::Total lymphoid irradiation (TLI) induces a unique state of immunosuppression. Although permanent bone marrow chimerism has been obtained in rodents prepared by TLI, uniform marrow engraftment has been more difficult to obtain in larger mammals. Accordingly, studies were performed to assess the immunologic perturbation...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/00007890-198307000-00004

    authors: Lowry RP,Carpenter CB,Gurley KE,Merrill JP

    更新日期:1983-07-01 00:00:00

  • A Phase I/II Trial of the Interleukin-6 Receptor-Specific Humanized Monoclonal (Tocilizumab) + Intravenous Immunoglobulin in Difficult to Desensitize Patients.

    abstract:BACKGROUND:Current desensitization (DES) methods are not always effective. Thus, novel, more effective approaches are desirable. Interleukin (IL)-6 is an attractive target as it promotes B-cell differentiation to plasma cells, is important for immunoglobulin production, and induces Th17 cells. Here, we undertook a phas...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/TP.0000000000000741

    authors: Vo AA,Choi J,Kim I,Louie S,Cisneros K,Kahwaji J,Toyoda M,Ge S,Haas M,Puliyanda D,Reinsmoen N,Peng A,Villicana R,Jordan SC

    更新日期:2015-11-01 00:00:00

  • Impact of Rural Residence on Kidney Transplant Rates Among Waitlisted Candidates in the VA Transplant Programs.

    abstract:BACKGROUND:Although proportionally more veterans live in rural areas compared to nonveterans, the impact of rurality status on kidney transplantation (KTP) access among veterans is unknown. Our objective was to study KTP rates among veterans listed for KTP and to compare the impact of rurality status on KTP rates among...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/TP.0000000000002624

    authors: O'Shea AMJ,Franciscus CL,Kaboli PJ,Kalil RS

    更新日期:2019-09-01 00:00:00

  • Reversibility of allograft arteriosclerosis after retransplantation to donor strain.

    abstract::The rat aortic transplant model was modified to investigate whether the vascular wall changes on chronic rejection are reversible. DA (RT1a) aortas were first transplanted to WF (RT1a) recipients. The first transplantation was accompanied, as described earlier, by an increase in intimal cellularity and thickness and t...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/00007890-199608270-00016

    authors: Mennander A,Häyry P

    更新日期:1996-08-27 00:00:00

  • Cyclosporine's effect on functional reserve in the renal allograft.

    abstract::Thirteen renal allograft recipients (6 patients on cyclosporine/7 patients on azathioprine) participated in a short-term oral protein-loading study to determine the effect of cyclosporine on an allograft's functional reserve. The baseline glomerular filtration rate of the two groups were similar (52 +/- 18 ml/min/1.73...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/00007890-199101000-00030

    authors: Nunley JR,King A,Comstock T,Posner M,Marshall C,Sica DA

    更新日期:1991-01-01 00:00:00

  • The effect of agents which modulate levels of the cyclic nucleotides on human lymphotoxin secretion and activity in vitro.

    abstract::The ability of concanavalin-A (Con-A) to activate lymphocytes to secrete human lymphotoxin (LT) was tested in the presence of agents known to modify the intracellular levels of cyclic nucleotides (cAMP and cGMP). Lymphocytes were treated with these agents at different stages of activation: (1) during the first encount...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/00007890-197510000-00010

    authors: Prieur AM,Granger GA

    更新日期:1975-10-01 00:00:00

  • Protection of porcine aortic endothelial cells from complement-mediated cell lysis and activation by recombinant human CD59.

    abstract::Discordant xenogeneic organ transplantation is a potential solution to the critical shortage of suitable donor organs. However, clinical application of xenotransplantation with physiologically suitable organs such as those from the pig, is currently limited by the lack of agents to prevent antibody and complement-medi...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:

    authors: Kennedy SP,Rollins SA,Burton WV,Sims PJ,Bothwell AL,Squinto SP,Zavoico GB

    更新日期:1994-05-27 00:00:00

  • The isolated perfused rat spleen. An original method for studying the function of hepatocytes transplanted into the spleen.

    abstract::The aim of this study was to assess directly the function of isolated hepatocytes 1 year after transplantation into the spleen, using an original model of isolated rat-spleen perfusion. Three specific liver functions, albumin synthesis, indocyanine-green clearance, and antipyrine oxidation, were studied. Five x 10(6) ...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:

    authors: Panis Y,Puts JP,Ballet F,Penin E,Delelo R,Verthier N,Nordlinger B

    更新日期:1990-04-01 00:00:00

  • Renal Transplantation From Pediatric Donors in the United Kingdom.

    abstract:BACKGROUND:Significant disparity exists in the United Kingdom between the need for organ transplant and supply of deceased donor organs. In the recent years, efforts to increase donation has improved the rate of mainly deceased donors after circulatory death and from older donors. The rate of donation from pediatric po...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/TP.0000000000000575

    authors: Dave RV,Hakeem AR,Dawrant MJ,Ecuyer CL,Lewington AJ,Attia MS,Hostert L,Finlay E,Ahmad N

    更新日期:2015-09-01 00:00:00

  • Recovery of graft function in pediatric kidney transplantation is not affected by delayed introduction of cyclosporine.

    abstract:BACKGROUND:Delayed graft function and acute rejections adversely affect the long-term survival of kidney transplantation. To decrease the incidences of these phenomena, we changed the initial immunosuppressive protocol in pediatric kidney transplantation in The Netherlands. METHODS:We compared a cohort (n=123) treated...

    journal_title:Transplantation

    pub_type: 杂志文章,多中心研究

    doi:10.1097/TP.0b013e318187c3ad

    authors: Cransberg K,Bouts AH,Cornelissen EA,Lilien MR,Van Hoeck KJ,Hop WC,Nauta J

    更新日期:2008-11-15 00:00:00

  • Pretransplant Cancer in Kidney Recipients in Relation to Recurrent and De Novo Cancer Incidence Posttransplantation and Implications for Graft and Patient Survival.

    abstract:BACKGROUND:Whether kidney transplant recipients who were treated for a malignant tumor before transplantation are at an increased risk of developing a tumor posttransplantation has not been adequately quantified and characterized. METHODS:We studied more than 270 000 patients on whom pretransplant and posttransplant m...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/TP.0000000000002459

    authors: Unterrainer C,Opelz G,Döhler B,Süsal C,Collaborative Transplant Study.

    更新日期:2019-03-01 00:00:00

  • Relationship between ABO blood group and levels of Gal alpha,3Galactose-reactive human immunoglobulin G.

    abstract:BACKGROUND:The terminal Gal alpha1,3Galactose (alphaGal) determinant is present on all porcine glycoproteins and glycolipids, but is not expressed by human cells. Consequently human sera contain anti-alphaGal natural antibodies. The human blood group B antigen [Gal alpha1,3(Fuc1,2)Galactose] is differentiated from the ...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/00007890-199708150-00032

    authors: McMorrow IM,Comrack CA,Nazarey PP,Sachs DH,DerSimonian H

    更新日期:1997-08-15 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

  • Apparent lack of H-Y-specific suppressor cells in female mice given male spleen cells intravenously.

    abstract::Mice given a pretransplant i.v. infusion of spleen cells from donors incompatible with the recipients with respect to individual minor H antigens exhibit a delayed rejection of skin grafts from these incompatible donors. Attempts were made to detect suppressor T cells, possibly induced by the i.v. infusion of donor ce...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/00007890-199001000-00034

    authors: Johnson LL

    更新日期:1990-01-01 00:00:00

  • Crossreactivity between human and canine Ia antigens using a mouse monoclonal antibody (CIA).

    abstract::A mouse monoclonal antibody (CIA) produced against human Ia antigens that reacts with 20-30% of human peripheral blood lymphocytes was found to react with more than 90% of dog lymphocytes. Less than 41% of the Ia-positive dog lymphocytes expressed surface immunoglobulins. Immunoprecipitation studies with 125I-labeled ...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/00007890-198308000-00016

    authors: Iwaki Y,Terasaki PI,Kinukawa T,Thai TH,Root T,Billing R

    更新日期:1983-08-01 00:00:00

  • Immunoprotection and Functional Improvement of Allogeneic Islets in Diabetic Mice, Using a Stable Indoleamine 2,3-Dioxygenase Producing Scaffold.

    abstract:BACKGROUND:We have previously shown that an immunomodulatory enzyme, indoleamine 2,3-dioxygenase (IDO) in dermal fibroblasts generates a tryptophan-deficient environment that selectively inhibits proliferation and induces apoptosis of bystander CD4+ and CD8+ T cells, but not pancreatic islets. Because these immune cell...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/TP.0000000000000661

    authors: Hosseini-Tabatabaei A,Jalili RB,Khosravi-Maharlooei M,Hartwell R,Kilani RT,Zhang Y,Ghahary A

    更新日期:2015-07-01 00:00:00

  • Identification of MHC II-restricted minor histocompatibility antigens after HLA-identical stem-cell transplantation.

    abstract:BACKGROUND:After allogeneic hematopoietic stem-cell transplantation (HSCT), donor-derived T cells may elicit graft-versus-host disease (GVHD) and graft-versus-tumor (GVT) responses. The main targets of GVHD and GVT responses after human leukocyte antigen (HLA)-identical HSCT are minor histocompatibility antigens (mHAgs...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/TP.0b013e3181f5470c

    authors: Milosevic S,Bachnick B,Karim K,Bornkamm GW,Witter K,Gerbitz A,Mautner J,Behrends U

    更新日期:2010-11-15 00:00:00

  • Graft-versus-host disease in the absence of the spleen after allogeneic bone marrow transplantation.

    abstract:BACKGROUND:The spleen is considered to be an important secondary lymphoid organ where acute graft-versus-host disease (GVHD) is initiated by donor T cells that recognize host alloantigens after allogeneic bone-marrow transplantation (BMT). The influence of splenectomy on the development of GVHD prior to BMT has yet to ...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/00007890-200205270-00027

    authors: Clouthier SG,Ferrara JL,Teshima T

    更新日期:2002-05-27 00:00:00

  • Immunobiology of xenogeneic cornea grafts in mouse eyes. II. Immunogenicity of xenogeneic cornea tissue grafts implanted in anterior chamber of mouse eyes.

    abstract:BACKGROUND:Xenogeneic corneal fragments (guinea pig) are highly resistant to immune rejection in the anterior chamber of mouse eyes. Because guinea pigs and mice are discordant (i.e., mouse serum normally contains guinea pig reactive xenoantibodies), we wished to determine the extent to which xenogeneic corneal fragmen...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/00007890-200002270-00025

    authors: Tanaka K,Streilein JW

    更新日期:2000-02-27 00:00:00

  • Combined liver-kidney transplantation in primary hyperoxaluria type 1. Bone histopathology and oxalate body content.

    abstract::In three patients with end-stage renal failure due to primary hyperoxaluria type 1, successful combined liver-kidney transplantation enabled us to assess the insoluble oxalate pool, which was compared with the histopathological changes observed in iliac crest biopsy specimens. Good correlation was observed between the...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/00007890-199506270-00010

    authors: Toussaint C,Vienne A,De Pauw L,Gelin M,Janssen F,Hall M,Schurmans T,Pasteels JL

    更新日期:1995-06-27 00:00:00

  • Cytomegalovirus induced up-regulation of LFA-3 (CD58) and ICAM-1 (CD54) is a direct viral effect that is not prevented by ganciclovir or foscarnet treatment.

    abstract::Cytomegalovirus (CMV) is a major pathogen in transplant recipients and AIDS patients, and the virus may also play a role in allograft rejection. Previous work from this laboratory demonstrated increased cell surface expression of the adhesion molecules ICAM-1 (CD54) and LFA-3 (CD58) following CMV infection in vitro. W...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/00007890-199610270-00014

    authors: Craigen JL,Grundy JE

    更新日期:1996-10-27 00:00:00