Assessment of Prognostic Factors and Projection of Outcomes in Renal Transplantation

Krakauer, Henry; Ek, Spees; Wk, Vaughn; Js, Grauman; Jp, Summe; Rc, Bailey

doi:10.1097/00007890-198310000-00005

Cited by 31 publications

(6 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…An increased prognosis for long-term allograft survival in Blacks as compared to White, Hispanic and Asian populations is evidenced in studies demonstrating that before the widespread use of cyclosporine (CsA), 1-and 3-year posttransplant allograft survival rates were 6% to 10% lower in Blacks than in Whites (15)(16)(17). Despite many advances in immunosuppressive therapies, increased HLA matching and the use of living-related donors (LRD), the incidence of renal allograft failure among Blacks remains disproportionately high.…”

Section: Introductionmentioning

confidence: 99%

Ethnicity Greatly Influences Cytokine Gene Polymorphism Distribution

Hoffmann

Stanley

Cox

et al. 2002

American Journal of Transplantation

294

205

View full text Add to dashboard Cite

Polymorphisms in the regulatory regions of cytokine genes are associated with high and low cytokine production and may modulate the magnitude of alloimmune responses following transplantation. Ethnicity influences allograft half-life and the incidence of acute and chronic rejection. We have questioned whether ethnic-based differences in renal allograft survival could be due in part to inheritance of cytokine polymorphisms. To address that question, we studied the inheritance patterns for polymorphisms in several cytokine genes (IL-2, IL-6, IL-10, TNF-a, TGF-b, and IFNg) within an ethnically diverse study population comprised of 216 Whites, 58 Blacks, 25 Hispanics, and 31 Asians. Polymorphisms were determined by allele-specific polymerase chain reaction and restriction fragment length analysis. We found striking differences in the distribution of cytokine polymorphisms among ethnic populations. Specifically, significant differences existed between Blacks and both Whites and Asians in the distribution of the polymorphic alleles for IL-2. Blacks, Hispanics and Asians demonstrated marked differences in the inheritance of IL-6 alleles and IL-10 genotypes that result in high expression when compared with Whites. Those of Asian descent exhibited an increase in IFN-g genotypes that result in low expression as compared to Whites. In contrast, we did not find significant ethnic-based differences in the inheritance of polymorphic alleles for TNF-a. Our results show that the inheritance of certain cytokine gene polymorphisms is strongly associated with ethnicity. These differences may contribute to the apparent influence of ethnicity on allograft outcome.

show abstract

Section: Introductionmentioning

confidence: 99%

Ethnicity Greatly Influences Cytokine Gene Polymorphism Distribution

Hoffmann

Stanley

Cox

et al. 2002

American Journal of Transplantation

294

205

View full text Add to dashboard Cite

show abstract

“…There are contradictory reports regarding the effect of splenectomy on allograft rejection following transplantation (1)(2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14). Some have reported a beneficial effect of splenectomy either pre-or peritransplantation (1-4,6, 7, 9, 10) and have attributed this benefit to a reduction in antibody production (I, 2) or improved leukocyte count and therefore tolerance to azathioprine (AZA) (3, 4,6,10,15).…”

mentioning

confidence: 99%

Untitled

Samimi¹,

Irish²,

Eghtesad³

et al. 1998

Digestive Diseases and Sciences

View full text Add to dashboard Cite

Between January 1987 and October 1991, 1466 patients underwent consecutive Orthotopic Liver Transplantation (OLTx) at the University of Pittsburgh. Forty of these patient's had concomitant splenectomy with OLTx. These patients were compared to 147 randomly selected OLTx patients without splenectomy within the same time period. One-year patient and graft survival (PS and GS) were lower in splenectomized (Splx) patients compared to nonsplenectomized (non-Splx) patients (59% vs 86% PS, 55% vs 80% GS, respectively). One-month and one-year patient mortality in the Splx group was higher than in the non-splx patients (20% vs 3.4%, P < 0.001 for one month; 40% vs 14.3%, P = 0.003 for one year, respectively). One-month and one-year sepsis-related mortality was also high in Splx patients (17.5% vs 2.7%, P = 0.0022, for one month, and 30% vs 11.5%, P = 0.0043, for one year, respectively). We conclude that concomitant splenectomy with OLTx has a significantly higher patient mortality mainly due to its septic complications and, at present, unless there is a specific indication for a splenectomy, the routine addition of this procedure to liver allograft surgery would not be recommended.

show abstract

“…Finn reported that contralateral nephrectomy performed 2 weeks after ischemic injury resulted in increased renal plasma flow and accelerated the renal function recovery of the postischemic kidney. Furthermore, some clinical studies showed that bilateral native nephrectomy was associated with a significant increase in graft survival in first time recipients of deceased‐donor renal transplants . This increase was most marked in patients who experienced delayed graft function, as suggested by experimental studies.…”

Section: Discussionmentioning

confidence: 96%

Residual urinary volume is a risk factor for primary nonfunction in kidney transplantation

et al. 2015

View full text Add to dashboard Cite

SummaryPrimary nonfunction is a severe complication after kidney transplantation. Residual renal function could be a risk factor for this complication in the current era of kidney transplantation from extended criteria donors (ECD). This is a singlecenter case-control study. Between 2000 and 2012, 1112 patients received a kidney transplant from a deceased donor. We identified 56 cases of early graft loss (kidney that never recover renal function and/or graft thrombosis <48 h after kidney transplantation). As controls we used patients receiving the contralateral kidney. Donor age was 55 AE 17 years with 57% fulfilling ECD criteria. Among the 56 cases, 14 were due to vascular rejection and 42 to primary nonfunction. Risk factors for early graft loss due to vascular rejection were previous transplant, time on dialysis, and HLA sensitization. Risk factors for primary nonfunction were first transplant, short period on dialysis, mainly peritoneal dialysis, and a residual urinary volume ≥500 ml/24 h. Conditional logistic regression analysis showed that residual urinary volume (OR = 20.01) rather than the dialysis modality was a major risk factor for primary nonfunction. In conclusion, residual urinary volume seems to be a risk factor for primary nonfunction in the current era of kidney transplantation.

show abstract

Assessment of Prognostic Factors and Projection of Outcomes in Renal Transplantation

Cited by 31 publications

References 0 publications

Ethnicity Greatly Influences Cytokine Gene Polymorphism Distribution

Ethnicity Greatly Influences Cytokine Gene Polymorphism Distribution

Untitled

Residual urinary volume is a risk factor for primary nonfunction in kidney transplantation

Contact Info

Product

Resources

About