The first report from the patient outcomes registry for transplant effects on life (PORTEL): differences in side‐effects and quality of life by organ type, time since transplant and immunosuppressive regimens

Abstract

Transplant recipients report good to excellent levels of QOL, however, side-effects associated with immunosuppressive regimens impair post-transplant QOL. Problems in certain domains, such as mobility, are found to increase with time since transplant. Tacrolimus-based regimens are associated with fewer and less severe side-effects than cyclosporine-based regimens in key domains that affect post-transplant QOL.

Clinical canine spinal cord injury provides an opportunity to examine the issues in translating laboratory techniques into practical therapy

“…A drawback to the use of adult allograft cells is that they are likely to be immunogenic and elicit a rejection response -not only destroying the cells but also causing further tissue injury -unless immunosuppressive drugs are also administered. Such drugs are not without side effects 93 and may vary in their ability to prevent rejection in different patient-transplant interactions, thereby introducing another source of variability in the assessment of outcome. Autologous sources are therefore preferable.…”

Effects of fibroblasts Derived from the Olfactory Bulb and Nasal Olfactory Mucosa on Proliferation of Olfactory Ensheating Cells Harvested from the Olfactory Bulb

“…One of the merits of the use of OECs is that they are available from an autologous source, so there is no need for a donor or immunosuppression therapy after transplantation [7,24]. The most reliable source of OECs is thought to be the olfactory bulb (OB), but the OB is relatively inaccessible, and harvesting OECs from it may cause serious neurological complications [5,11].…”

Time-Related Centile Ranges for Quality of Life Outcomes in Renal Transplantation

“…The instrument was comprised of 100 items organized to capture demographic variables, clinical outcomes, medications, and side effects (Hathaway, Winsett, Prendergast, & Subaiya, 2003). The content of the survey addressed each of the five domains described in the QoL framework for the registry: QoL, health factors, social factors, major health factors, and major life events.…”

“…The goals of the PORTEL registry included the collection of longitudinal data following solid organ transplantation, documenting of the side effects of immunosuppressive therapy, and identifying predictors of QoL post transplantation with the intent of using the data to establish norms for QoL following transplantation (Hathaway, Winsett, Prendergast, & Subaiya, 2003). The PORTEL survey instrument was based on a QoL framework composed of 5 interrelated domains that included QoL, health and social factors and, major health and major life events (Hathaway, et al, 2003b) that influence both the physical and psychosocial aspects of QoL.…”

“…Site-centric recruitment was accomplished through four transplantation centers representing different regions of the United States; Unversity of Southern California, University of Alabama, Birmingham, University of Tennessee Health Science Center, and University of Minnesota. Transplantation centers participating in data collection received IRB approval from their institution prior to enrollment of subjects (Hathaway, Winsett, Prendergast, & Subaiya, 2003). The PORTEL database represented a more diverse sample of the population of transplant recipients than a sample drawn from a single institution and, as such, was appropriate for creation of time-related centile ranges for use in a variety of settings.…”