Renal replacement therapy and orthotopic liver transplantation: the role of continuous veno-venous hemodialysis.

Abstract:

BACKGROUND:The need for renal replacement therapy (RRT) either before or after orthotopic liver transplant (OLTX) has been reported to be a poor prognostic indicator for survival. Use of continuous veno-venous hemodialysis (CVVHD) for RRT has been reported in three series of OLTX patients with high 90-day mortality rates of 57-60%. We have examined our patient population to determine the effect of necessity and type of RRT on patient survival after OLTX. METHODS:We analyzed 1535 OLTX that were performed at our institution from 1985 through 1999, 1037 from 1985 to 1995 (period I) and 498 from 1996 to 1999 (period II). Combined liver-kidney transplants were excluded from analysis. Hospital dialysis unit records and a prospectively maintained database on all OLTX patients served as the source of data. Patients were classified into groups defined on whether or not they received RRT, when they received RRT, and the type of RRT. Groups were compared for preoperative intensive care unit status, time on the waiting list, laboratory variables, 90-day postoperative mortality, 1-year patient survival, and absolute survival. RESULTS:Use of RRT increased from 8.29% in period I to 12.45% in period II, along with increased median waiting times. In period I, patients receiving preoperative RRT had a 90-day mortality (0%) and a 1-year survival (89.5%) almost identical to those patients who never required RRT (1.7% and 90.6%). Patients who developed acute renal failure postoperatively requiring RRT, however, had a 90-day mortality of 28.6% and a 1-year survival of 55%. In period II, patients requiring RRT had a 90-day mortality of 39.7% and a 1-year actuarial survival of 54.5% compared with 6.9% and 88.6% in patients never requiring RRT. Patients treated with CVVHD had a 90-day mortality of 42% compared with 25% in patients treated with hemodialysis alone. However, patients receiving CVVHD both pre- and postoperatively had a 90-day mortality of 27.7% vs. 50% in those patients who only received CVVHD postoperatively. Patients who developed acute renal failure postoperatively, which required RRT, regardless of therapy, had a 1-year survival of only 41.0% compared with a 1-year survival of 73.6% in those patients started on RRT preoperatively, P=0.03. CONCLUSIONS:The need for RRT has increased along with waiting time in OLTX patients. Patients developing the need for RRT postoperatively have an increased 90-day mortality and lower 1-year survival with the highest being present in patients receiving CVVHD, which was started postoperatively. These findings may reflect a trend toward a sicker population awaiting OLTX and emphasize the negative impact of renal failure on survival after OLTX.

journal_name

Transplantation

journal_title

Transplantation

authors

Gonwa TA,Mai ML,Melton LB,Hays SR,Goldstein RM,Levy MF,Klintmalm GB

doi

10.1097/00007890-200105270-00012

subject

Has Abstract

pub_date

2001-05-27 00:00:00

pages

1424-8

issue

10

eissn

0041-1337

issn

1534-6080

journal_volume

71

pub_type

杂志文章
  • A possible explanation for anemia in patients treated with mycophenolic acid.

    abstract:BACKGROUND:Clinical studies suggest that the immunosuppressant mycophenolate mofetil is associated with anemia. However, the mechanism for this is not known. Here, we studied the effect of mycophenolic acid (MPA), the active metabolite of mycophenolate mofetil, on erythropoiesis in vitro. METHODS:Both UT-7 cells and p...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/TP.0b013e318238da98

    authors: Pile T,Kieswich J,Harwood S,Yaqoob MM

    更新日期:2011-12-27 00:00:00

  • Lymphocytic bronchitis unrelated to acute graft-versus-host disease in canine marrow graft recipients.

    abstract::We reviewed coded autopsy material from 71 dogs, 46 receiving allogeneic and 25 receiving autologous bone marrow transplants, to evaluate the hypothesis that lymphocytic bronchitis is associated with severe acute graft-versus-host disease (GVHD). We found no significant correlation between the presence of lymphocytic ...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/00007890-198403000-00003

    authors: O'Brien KD,Hackman RC,Sale GE,Prentice R,Deeg J,Thomas ED,Storb R

    更新日期:1984-03-01 00:00:00

  • Increase of proliferating renal progenitor cells in acute tubular necrosis underlying delayed graft function.

    abstract:BACKGROUND:Delayed graft function (DGF) is associated with acute tubular necrosis. In this setting, surviving tubular cells may proliferate and replace injured cells. CD133Pax-2cells may play a role in the regeneration of tubular damage. The aim of this study was to demonstrate the presence of these cells in human kidn...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/TP.0b013e31816a8891

    authors: Loverre A,Capobianco C,Ditonno P,Battaglia M,Grandaliano G,Schena FP

    更新日期:2008-04-27 00:00:00

  • Rapamycin: immunosuppression, hyporesponsiveness, and side effects in a porcine renal allograft model.

    abstract::Rapamycin prolongs allograft survival and induces donor-specific tolerance in some small animal transplant models. Large animal studies, however, are limited. We studied rapamycin in a porcine renal allograft model. Donor-recipient combinations were chosen based on high response in pretransplant MLCs. Allografts were ...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:

    authors: Almond PS,Moss A,Nakhleh RE,Melin M,Chen S,Salazar A,Shirabe K,Matas AJ

    更新日期:1993-08-01 00:00:00

  • A prospective study investigating the cost effectiveness of intraoperative blood salvage during liver transplantation.

    abstract:BACKGROUND:Adult orthotopic liver transplantation is associated with significant use of allogenic blood products, which places considerable demands on finite resources. This could be reduced by autologous red cell salvage use, and we evaluated its cost effectiveness in this prospective study. METHODS:Intraoperative au...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/01.tp.0000199318.17013.c5

    authors: Phillips SD,Maguire D,Deshpande R,Muiesan P,Bowles MJ,Rela M,Heaton ND

    更新日期:2006-02-27 00:00:00

  • Endothelial chimerism in transplantation: Looking for needles in a haystack.

    abstract::Endothelial chimerism in transplanted organs is a fascinating phenomenon, indicative of a mechanism by which progenitor recipient cells replace the donor endothelium. It has been hypothesized that this replacement could lead to a decrease in alloreactivity and thus would positively influence graft outcome. However, re...

    journal_title:Transplantation

    pub_type: 杂志文章,评审

    doi:10.1097/01.tp.0000231446.41051.98

    authors: Koopmans M,Kremer Hovinga IC,Baelde HJ,de Heer E,Bruijn JA,Bajema IM

    更新日期:2006-07-15 00:00:00

  • Cell and extracellular matrix rejection in arterial concordant and discordant xenografts in the rat.

    abstract::Vascularized xenografts are rejected acutely and hyperacutely in concordant or discordant combinations, respectively. We investigated the impact of the donor-recipient combination on the rejection of arterial xenografts, analyzing the cellular and extracellular matricial compartments. Aortic xenografts were performed ...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/00007890-199609270-00017

    authors: Allaire E,Mandet C,Bruneval P,Bensenane S,Becquemin JP,Michel JB

    更新日期:1996-09-27 00:00:00

  • Escaping from rejection.

    abstract::Since the earliest days of transplantation, immunobiologists have sought means to prevent recognition and rejection of foreign tissue. The goal of these strategies is the retention of recipient immune function while selectively avoiding graft injury. Although considerable theoretical and technical problems remain, an ...

    journal_title:Transplantation

    pub_type: 杂志文章,评审

    doi:10.1097/TP.0b013e3181bcc93a

    authors: Lynch RJ,Platt JL

    更新日期:2009-12-15 00:00:00

  • Cold-storage preservation of the canine and rat pancreas prior to islet isolation.

    abstract::Cold-storage preservation of the canine pancreas prior to islet isolation has previously been noted to reduce the intrasplenic islet autograft success rate; but the mechanism of this deleterious effect has not been determined. We undertook a study in both outbred dogs and Lewis (RT1-1) rats to determine the influence ...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/00007890-198901000-00007

    authors: Munn SR,Kaufman DB,Field MJ,Viste AB,Sutherland DE

    更新日期:1989-01-01 00:00:00

  • Acceptance of cardiac allografts by lethally irradiated rats repopulated with syngeneic bone marrow. Role of class I and class II alloantigens.

    abstract::LEW rats (RT1l) that are lethally irradiated and repopulated with syngenic bone marrow accept WF (RT1u) cardiac allografts. If bone marrow repopulation is delayed for two days after irradiation and operation, grafts containing passenger leukocytes (nonperfused grafts) are generally rejected, but perfused grafts, which...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/00007890-198404000-00013

    authors: Hartnett LC,Dittmer JE,Schwadron RB

    更新日期:1984-04-01 00:00:00

  • Safety and efficacy of statin therapy in patients switched from cyclosporine a to sirolimus after cardiac transplantation.

    abstract:INTRODUCTION:Statins are an established therapy after cardiac transplantation. Sirolimus (Srl) has been used successfully in cardiac transplant patients. However, potential side effects are hyperlipidemia and interactions with statins. The aim of the study was to evaluate the safety and efficacy of statin therapy after...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/TP.0b013e3181910eb2

    authors: Aliabadi AZ,Mahr S,Dunkler D,Grömmer M,Zimpfer D,Wolner E,Grimm M,Zuckermann AO

    更新日期:2008-12-27 00:00:00

  • Fine specificity and idiotype diversity of the murine anti-HLA-A2, A28 monoclonal antibodies CR11-351 and KS1.

    abstract::The monoclonal antibodies (MoAb) CR11-351 and KS1 are secreted by hybridomas generated with splenocytes from BALB/c mice immunized with the cultured human B lymphoid cells LG-2 (HLA-A2,A2,B27,B27). The 2 monoclonal antibodies immunoprecipitated components with a superimposable 2-dimensional gel electrophoretic profile...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/00007890-198803000-00026

    authors: Tsujisaki M,Sakaguchi K,Igarashi M,Richiardi P,Perosa F,Ferrone S

    更新日期:1988-03-01 00:00:00

  • Benefit of phosphodiesterase 4 inhibitors as supplemental therapy after lung transplantation concerning their antiproliferative effects: an experimental study using a heterotopic rodent model.

    abstract:BACKGROUND:Recent advances in the understanding of immunomodulatory properties of phosphodiesterase 4 (PDE4) inhibitors recommend these drugs for immunosuppressive therapy after lung transplantation. The potency of three PDE4 inhibitors was tested using an established model of heterotopic tracheal transplantation in ra...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/00007890-200208150-00007

    authors: Schade I,Roth-Eichhorn S,Kasper M,Kuss H,Plötze K,Funk RH,Schüler S

    更新日期:2002-08-15 00:00:00

  • Failure of in vitro assays to predict accurately the existence of neonatally induced H-2 tolerance.

    abstract::Tolerogen-specific alloreactivity, in the form of mixed lymphocyte responses and cell mediated lympholysis, was measured in vitro using lymphocytes from mice that received neonatal inoculations of H-2 semiallogeneic hematopoietic cells. It was found that depletion of specific alloreactivity, as detected by these assay...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:

    authors: Streilein JW,Strome P,Wood PJ

    更新日期:1989-10-01 00:00:00

  • Reversal of intrapulmonary arteriovenous shunting detected by two-dimensional contrast-enhanced echocardiography after liver transplantation.

    abstract:BACKGROUND:Intrapulmonary arteriovenous shunting (IPS), occasionally associated with advanced liver disease, may reverse after liver transplantation (LTx). Two-dimensional contrast-enhanced echocardiography, a convenient noninvasive study, has never been used to demonstrate disappearance of IPS after LTx. METHODS:For ...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/00007890-200002270-00035

    authors: Hasegawa T,Kamiyama M,Azuma T,Sasaki T,Okada A,Miwatani T,Matsushita T

    更新日期:2000-02-27 00:00:00

  • The prevalence of coronary artery disease in liver transplant candidates over age 50.

    abstract::The prevalence of angiographically proven coronary artery disease (CAD) in adults with end-stage liver disease who undergo evaluation for liver transplantation is unknown; also it is unclear if cholestatic liver disease represents an independent risk factor. Patients with end-stage liver disease over age 50 having liv...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:

    authors: Carey WD,Dumot JA,Pimentel RR,Barnes DS,Hobbs RE,Henderson JM,Vogt DP,Mayes JT,Westveer MK,Easley KA

    更新日期:1995-03-27 00:00:00

  • Neutrophilic tubulitis as a marker for urinary tract infection in renal allograft biopsies with C4d deposition.

    abstract:BACKGROUND:Neutrophilic tubulitis accompanied by intratubular neutrophil clusters in the renal allograft is a surrogate marker for urinary tract infection (UTI). Overlapping histologic findings can occur in antibody-mediated rejection, which is characterized by peritubular capillary (PTC) deposition of C4d. This study ...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/TP.0b013e31819ca304

    authors: Gupta G,Shapiro R,Girnita A,Batal I,McCauley J,Basu A,Tan H,Randhawa P

    更新日期:2009-04-15 00:00:00

  • Developing Statistical Models to Assess Transplant Outcomes Using National Registries: The Process in the United States.

    abstract::Created by the US National Organ Transplant Act in 1984, the Scientific Registry of Transplant Recipients (SRTR) is obligated to publicly report data on transplant program and organ procurement organization performance in the United States. These reports include risk-adjusted assessments of graft and patient survival,...

    journal_title:Transplantation

    pub_type: 杂志文章,评审

    doi:10.1097/TP.0000000000000891

    authors: Snyder JJ,Salkowski N,Kim SJ,Zaun D,Xiong H,Israni AK,Kasiske BL

    更新日期:2016-02-01 00:00:00

  • The decrease in organ donations from 1985 to 1990 caused by increasing medical contraindications and refusals by relatives.

    abstract::After the progressive improvement in the results of organ transplantation we now face the challenge of shortage in organ supply. The decreasing number of organ retrievals performed in 1990 at our hospital has raised questions concerning loss of potential organ donors and opposition to donation by the next of kin. We i...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/00007890-199207000-00015

    authors: Faltin DL,Jeannet M,Suter PM

    更新日期:1992-07-01 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

  • Quantification of the islet product: presentation of a standardized current good manufacturing practices compliant system with minimal variability.

    abstract:BACKGROUND:Accurate islet quantification has proven difficult to standardize in a good manufacturing practices (GMP) approved manner. METHODS:The influence of assessment variables from both manual and computer-assisted digital image analysis (DIA) methods were compared using calibrated, standardized microspheres or is...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/TP.0b013e31820ae48e

    authors: Friberg AS,Brandhorst H,Buchwald P,Goto M,Ricordi C,Brandhorst D,Korsgren O

    更新日期:2011-03-27 00:00:00

  • Therapeutic effects of a non-β cell bioartificial pancreas in diabetic mice.

    abstract:BACKGROUND:Cell-based insulin therapies can potentially improve glycemic regulation in insulin-dependent diabetic patients. Enteroendocrine cells engineered to secrete recombinant insulin have exhibited glycemic efficacy, but have been primarily studied as uncontrollable growth systems in immune incompetent mice. Furth...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/TP.0000000000000247

    authors: Tiernan AR,Thulé PM,Sambanis A

    更新日期:2014-09-15 00:00:00

  • Differential effect of cyclosporine in vivo on the distribution of T cell subsets in the thymus, spleen, and lymph nodes.

    abstract::Cyclosporine treatment of BALB/c mice (at a dose of 20 mg/kg every other day for 3 weeks) caused a remarkable reduction in the PNA-, L3T4+Lyt-2- subset of thymocytes. A significant reduction of the L3T4+Lyt-2-subset was also observed in both the lymph node and spleen cells of CsA-treated mice, though the degree of the...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/00007890-198903000-00020

    authors: Hiramine C,Hojo K,Matsumoto H,Koseto M,Itoh M

    更新日期:1989-03-01 00:00:00

  • In vitro propagation and homing of liver-derived dendritic cell progenitors to lymphoid tissues of allogeneic recipients. Implications for the establishment and maintenance of donor cell chimerism following liver transplantation.

    abstract::Dendritic cell (DC) progenitors were propagated in liquid culture from nonparenchymal cells resident in normal mouse (B10.BR; H-2k, I-E+) liver in response to granulocyte-macrophage colony stimulating factor (GM-CSF). The liver-derived DC progenitors were MHC class II-/dim and did not express counter receptors for CTL...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/00007890-199502270-00019

    authors: Thomson AW,Lu L,Subbotin VM,Li Y,Qian S,Rao AS,Fung JJ,Starzl TE

    更新日期:1995-02-27 00:00:00

  • Intercellular adhesion molecule-1 expression in endothelial cells is activated by cytomegalovirus immediate early proteins.

    abstract:BACKGROUND:Human cytomegalovirus (HCMV) infection is associated with allograft vasculopathy and rejection. One potential mechanism is vascular injury from immunologically mediated processes. HCMV infection has been shown to increase the constitutive expression of intercellular adhesion molecule-1 (ICAM-1). The objectiv...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/00007890-199901150-00023

    authors: Burns LJ,Pooley JC,Walsh DJ,Vercellotti GM,Weber ML,Kovacs A

    更新日期:1999-01-15 00:00:00

  • Topical use of cidofovir induced acute renal failure.

    abstract:BACKGROUND:Cidofovir has antiviral activity against a wide spectrum of DNA viruses. Several small studies have focused on the efficacy of topical cidofovir in various viral-induced diseases. We report a systemic complication of such therapy. CASE REPORT:A bone marrow transplant recipient with chronic renal failure dev...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/00007890-200202270-00033

    authors: Bienvenu B,Martinez F,Devergie A,Rybojad M,Rivet J,Bellenger P,Morel P,Gluckman E,Lebbé C

    更新日期:2002-02-27 00:00:00

  • Preservation of Microvascular Integrity in Murine Orthotopic Tracheal Allografts by Clopidogrel.

    abstract:BACKGROUND:Survival after lung transplantation is mainly limited by the development of chronic lung allograft dysfunction (CLAD). The aim of this study was to investigate if platelet inhibition by clopidogrel has a functionally relevant influence on the microvascular integrity of orthotopic tracheal allografts as an an...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/TP.0000000000002571

    authors: Heim C,Khan MA,von Silva-Tarouca B,Kuckhahn A,Stamminger T,Ramsperger-Gleixner M,Nicolls MR,Weyand M,Ensminger SM

    更新日期:2019-05-01 00:00:00

  • Analysis of Post-Liver Transplant Hepatitis C Virus Recurrence Using Serial Cluster of Differentiation Antibody Microarrays.

    abstract:BACKGROUND:Hepatitis C virus (HCV) reinfection of the liver allograft after transplantation is universal, with some individuals suffering severe disease recurrence. Predictive markers of recurrent disease severity are urgently needed. In this study, we used a cluster of differentiation (CD) microarray to predict the se...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/TP.0000000000000617

    authors: Rahman W,Tu T,Budzinska M,Huang P,Belov L,Chrisp JS,Christopherson RI,Warner FJ,Bowden DS,Thompson AJ,Bowen DG,Strasser SI,Koorey D,Sharland AF,Yang JY,McCaughan GW,Shackel NA

    更新日期:2015-09-01 00:00:00

  • Treatment of established bone loss after renal transplantation with etidronate.

    abstract:BACKGROUND:Osteoporosis is a well-documented complication of organ transplantation. Bisphosphonates have been shown to be effective in preventing corticosteroid-induced osteoporosis in renal transplant recipients, but data are lacking for treatment of established osteoporosis. This study reports our clinical experience...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/00007890-200103150-00017

    authors: Arlen DJ,Lambert K,Ioannidis G,Adachi JD

    更新日期:2001-03-15 00:00:00

  • Engrafted human T and B lymphocytes form mixed follicles in lymphoid organs of human/mouse and human/rat radiation chimera.

    abstract:BACKGROUND:We recently described a new approach that enables the generation of human/mouse chimera by adoptive transfer of human peripheral blood mononuclear cells into lethally irradiated normal strains of mice or rats, radioprotected with bone marrow from donors with severe combined immune deficiency. In such human/m...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/00007890-199704270-00018

    authors: Burakova T,Marcus H,Canaan A,Dekel B,Shezen E,David M,Lubin I,Segal H,Yair R

    更新日期:1997-04-27 00:00:00