Factors Contributing to Long-Term Kidney Graft Survival in Eurotransplant

Thorogood, J.; Houwelingen, Hans C. van; Jj, van Rood; Fa, Zantvoort; Gm, Schreuder; Gg, Persijn

doi:10.1097/00007890-199207000-00027

Cited by 58 publications

(12 citation statements)

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“…Our results confirm those from previous studies: in cyclosporine‐treated recipients, grafts from female donors to male recipients have a lower survival than that of all the other grafts [7][8][9][10]. Moreover, they suggest that this poor outcome results neither from a lack of fit of the graft size relative to the recipient nor from cyclosporine‐induced toxicity as it is illustrated by the time‐evolution of serum creatinine values, daily doses and trough levels of cyclosporine, but from immunologic and non‐immunologic factors, combining their respective effects on graft survival early in the course of transplantation.…”

Section: Discussionsupporting

confidence: 91%

“…This difference was even more marked in regrafts than in first grafts and was confirmed by later studies of the same group: predicted 10‐yr survival rates were 36% in female donor to male recipient grafts and about 45% in all the other grafts [8]. Other authors obtained similar results [9][10]. The size of the female donor kidney relative to the male recipient, inducing nephron overload and aspecific gradual renal dysfunction, was putatively responsible for the poor long‐term outcome of grafts from female donors to male recipients [11].…”

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confidence: 54%

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Male recipients of kidneys from female donors are at increased risk of graft loss from both rejection and technical failure

Vereerstraeten

Wissing

Pauw

et al. 1999

Clinical Transplantation

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The aim of the present retrospective study was to uncover the factor(s) responsible for the poor outcome of cadaver kidney grafts from female donors in male recipients. The 741 transplantations performed at our center from August 1983 to September 1997 were distributed into four groups according to recipient and donor gender: female donor to female recipient (F to F: n = 117), male donor to female recipient (M to F: n = 172), female donor to male recipient (F to M: n = 170), and male donor to male recipient (M to M: n = 282). All the patients received immunosuppressive therapy based on corticosteroids and cyclosporine, associated or not with either azathioprine or prophylactic anti-lymphocyte globulin. Overall graft survival was lower in the F to M group than in the three other groups (p = 0.009). Failures due to rejection were more frequent during the 1st post-transplant trimester in female than in male donor grafts, irrespective of recipient gender (p = 0.025). All failures due to technical problems occurred during the first 3 months post-transplantation: they were more frequent in the F to M group than in the three other groups (p = 0.040): this could be related to the older age of the donors in the former group. After the first post-transplant year, failures due to causes other than rejection remained low in the F to F group but increased steadily in the three other groups (p = 0.007). Specific survival rates were not correlated with the time-evolution of mean serum creatinine values, daily doses and trough levels of cyclosporine in the four groups of grafts. In conclusion, the poor outcome of F to M grafts results from combined immunologic and technical factors exerting their effects early in the course of transplantation.

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Section: Discussionsupporting

confidence: 91%

mentioning

confidence: 54%

Male recipients of kidneys from female donors are at increased risk of graft loss from both rejection and technical failure

Vereerstraeten

Wissing

Pauw

et al. 1999

Clinical Transplantation

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“…However, unlike in KT, the effect of human leukocyte antigen (HLA) compatibility on LT outcome is controversial. [12][13][14][15] Because the data are obtained from cadaveric, mostly unrelated donor LTs, the introduction of living-related liver transplantation (LRLT) provides an opportunity to study the results of better matched transplants. The higher success rate in children with related-donor LT compared with unrelated or cadaveric liver transplants suggested an important role of histocompatibility in LT. 16 Recently, prospective analysis of the recipients transplanted with grafts from one or both haplotypeidentical parents has shown better graft survival and the possibility to withdraw immunosuppression in the 0-mismatch group.…”

Section: Discussionmentioning

confidence: 99%

Primary hyperoxaluria: Simultaneous combined liver and kidney transplantation from a living related donor

Astarcıoğlu

Karademir

Gülay

et al. 2003

Liver Transplantation

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Primary hyperoxaluria type 1 (PH1) is a rare inherited metabolic disorder in which deficiency of the liver enzyme AGT leads to renal failure and systemic oxalosis. Timely, combined cadaveric liver-kidney transplantation (LKT) is recommended for end-stage renal failure (ESRF) caused by PH1; however, the shortage of cadaveric organs has generated enthusiasm for living-related transplantation in years. Recently, successful sequential LKT from the same living donor has been reported in a child with PH1. We present a sister-to-brother simultaneous LKT in a pediatric patient who suffered from PH1 with ESRF. Twelve months after transplantation, his daily urine oxalate excretion was decreased from 160 mg to 19.5 mg with normal liver and renal allograft functions. In addition to the well-known advantages of living organ transplantation, simultaneous LKT may facilitate early postoperative hemodynamic stability and may induce immunotolerance and allow for low-dose immunosuppression. (Liver Transpl 2003;9:433-436.) P rimary hyperoxaluria type 1 (PH1) is a rare, inherited metabolic disorder caused by a deficiency of the liver-specific peroxisomal alanine-glyoxylate aminotransferase (AGT). It is characterized by increased synthesis and urinary excretion of oxalate that leads to renal failure attributable to urolithiasis, nephrocalcinosis, and, subsequently, to oxalate accumulation in various extra-renal tissues such as the skeleton and the cardiovascular system. Because the liver is the site of the metabolic defect, isolated kidney transplantation (KT) is not a reasonable therapeutic alternative because of a rapid diffuse oxalate deposition in the allograft. 1 Preemptive liver transplantation (LT) has been successfully performed in some children before serious renal damage occurred. 2 If end-stage renal failure (ESRF) has been reached, early simultaneous or sequential liver-KT (LKT) may avoid the deleterious consequences of systemic oxalosis. 3 Shortage of donor organs remains the critical factor limiting the use of organ transplantation. This shortage has generated enthusiasm for living-related transplantation, offering hope not only for children but also for adolescents and even adults. Partial LT alone or sequential LKT from living donors have been successfully performed for PH1. 4,5 To date, there have been no reports describing combined simultaneous LKT from the same living donor in the treatment of PH1 complicated with ESRF.

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“…This assay consisted of 64 different bead populations coated with purified (or recombinant) HLA-A or -B single antigens and divided into eight groups (sets [1][2][3][4][5][6][7][8]. Each set of beads contained eight different bead populations that can be separated from each other by the FL2 channel of a flow cytometer because each bead population has a unique FL2 channel-shift (14).…”

Section: Flow Cytometric Identification Of Anti-hla Class I Dsamentioning

confidence: 99%

“…S everal reports have described the beneficial effect of HLA matching on long-term graft survival in kidney transplantation (1)(2)(3)(4). Conventional donor/recipient HLA-A, -B and -DR compatibility takes into consideration six serologically defined HLA antigens, that is to say, six highly polymorphic "private epitopes" of specific HLA antigens.…”

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confidence: 99%

Public Epitope Specificity of HLA Class I Antibodies Induced by a Failed Kidney Transplant: Alloantibody Characterization by Flow Cytometric Techniques

et al. 2006

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Factors Contributing to Long-Term Kidney Graft Survival in Eurotransplant

Cited by 58 publications

References 0 publications

Male recipients of kidneys from female donors are at increased risk of graft loss from both rejection and technical failure

Male recipients of kidneys from female donors are at increased risk of graft loss from both rejection and technical failure

Primary hyperoxaluria: Simultaneous combined liver and kidney transplantation from a living related donor

Public Epitope Specificity of HLA Class I Antibodies Induced by a Failed Kidney Transplant: Alloantibody Characterization by Flow Cytometric Techniques

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