Journal ArticleDOI
Chronic renal failure after transplantation of a nonrenal organ.
Akinlolu O. Ojo,Philip J. Held,Friedrich K. Port,Robert A. Wolfe,Alan B. Leichtman,Eric W. Young,J.A Arndorfer,Laura L. Christensen,Robert M. Merion +8 more
TLDR
The five-year risk of chronic renal failure after transplantation of a nonrenal organ ranges from 7 to 21 percent, depending on the type of organ transplanted, and is associated with an increase by a factor of more than four in the risk of death.Abstract:
Background Transplantation of nonrenal organs is often complicated by chronic renal disease with multifactorial causes. We conducted a population-based cohort analysis to evaluate the incidence of chronic renal failure, risk factors for it, and the associated hazard of death in recipients of nonrenal transplants. Methods Pretransplantation and post-transplantation clinical variables and data from a registry of patients with end-stage renal disease (ESRD) were linked in order to estimate the cumulative incidence of chronic renal failure (defined as a glomerular filtration rate of 29 ml per minute per 1.73 m2 of body-surface area or less or the development of ESRD) and the associated risk of death among 69,321 persons who received nonrenal transplants in the United States between 1990 and 2000. Results During a median follow-up of 36 months, chronic renal failure developed in 11,426 patients (16.5 percent). Of these patients, 3297 (28.9 percent) required maintenance dialysis or renal transplantation. The five-year risk of chronic renal failure varied according to the type of organ transplanted - from 6.9 percent among recipients of heart-lung transplants to 21.3 percent among recipients of intestine transplants. Multivariate analysis indicated that an increased risk of chronic renal failure was associated with increasing age (relative risk per 10-year increment, 1.36; P Conclusions The five-year risk of chronic renal failure after transplantation of a nonrenal organ ranges from 7 to 21 percent, depending on the type of organ transplanted. The occurrence of chronic renal failure among patients with a nonrenal transplant is associated with an increase by a factor of more than four in the risk of death.read more
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Update on prevention, diagnosis, and treatment of chronic hepatitis B: AASLD 2018 hepatitis B guidance
Norah A. Terrault,Anna S. Lok,Brian J. McMahon,Kyong-Mi Chang,Jessica P. Hwang,Maureen M. Jonas,Robert S. Brown,Natalie Bzowej,John B. Wong +8 more
TL;DR: This AASLD 2018 Hepatitis B Guidance provides a data-supported approach to screening, prevention, diagnosis, and clinical management of patients with hepatitis B.
Journal ArticleDOI
The International Society of Heart and Lung Transplantation Guidelines for the care of heart transplant recipients
Maria Rosa Costanzo,Anne I. Dipchand,Randall C. Starling,Allen S. Anderson,Michael Chan,Shashank Desai,Savitri Fedson,Patrick W. Fisher,Gonzalo Gonzales-Stawinski,Luigi Martinelli,David C. McGiffin,Jon Smith,David O. Taylor,Bruno Meiser,Steven A. Webber,David A. Baran,Michael P. Carboni,Thomas J. Dengler,David L. Feldman,Maria Frigerio,Abdallah G. Kfoury,Daniel Kim,Jon A. Kobashigawa,Michael A. Shullo,Josef Stehlik,Jeffrey J. Teuteberg,Patricia A. Uber,Andreas Zuckermann,Sharon A. Hunt,Michael Burch,Geetha Bhat,Charles E. Canter,Richard E. Chinnock,Marisa G. Crespo-Leiro,Reynolds M. Delgado,Fabienne Dobbels,Kathleen L. Grady,W. Kao,Jaqueline Lamour,Gareth Parry,Jignesh Patel,Daniela Pini,Jeffrey A. Towbin,Gene Wolfel,Diego H. Delgado,Howard J. Eisen,Lee R. Goldberg,Jeff Hosenpud,Maryl R. Johnson,Anne Keogh,Clive Lewis,John B. O'Connell,Joseph G. Rogers,Heather J. Ross,Stuart D. Russell,Johan Vanhaecke,Amanda W. Rowe +56 more
TL;DR: Institutional Affiliations Chair Costanzo MR: Midwest Heart Foundation, Lombard Illinois, USA Task Force 1 Dipchand A: Hospital for Sick Children, Toronto Ontario, Canada; Starling R: Cleveland Clinic Foundation, Cleveland, Ohio, USA; Starlings R: University of Chicago, Chicago, Illinois,USA; Chan M: university of Alberta, Edmonton, Alberta, Canada ; Desai S: Inova Fairfax Hospital, Fairfax, Virginia, USA.
Journal ArticleDOI
Immunosuppressive Drugs for Kidney Transplantation
TL;DR: This review considers the use of immunosuppressive drugs in organ transplantation, focusing on renal transplantation.
Journal ArticleDOI
Calcineurin Inhibitor Nephrotoxicity
TL;DR: The authors critically review the current evidence relating systemic blood levels of cyclosporine and tacrolimus to calcineurin inhibitor nephrotoxicity, and summarize the data suggesting that local exposure to cycloporine or tacolimus could be more important than systemic exposure.
Journal ArticleDOI
Rational Development of LEA29Y (belatacept), a High‐Affinity Variant of CTLA4‐Ig with Potent Immunosuppressive Properties
Christian P. Larsen,Thomas C. Pearson,Andrew B. Adams,Paul L. Tso,Nozomu Shirasugi,Elizabeth Strobert,Daniel G. Anderson,Shannon R. Cowan,Karen Price,Naemura Joseph R,John Emswiler,Jo Anne L. Greene,Lori A. Turk,Jürgen Bajorath,Robert M. Townsend,David Hagerty,Peter S. Linsley,Robert J. Peach +17 more
TL;DR: An attempt to increase the biologic potency of the parent molecule a novel, modified version of CTLA4‐Ig, LEA29Y (belatacept), was constructed, resulting in a 10‐fold increase in potency in vitro and significant prolongation of renal allograft survival in a pre‐clinical primate model.
References
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Journal ArticleDOI
The seventh report of the joint National Committee on prevention, detection, evaluation and treatment of high blood pressure. The JNC 7 report
Aram V. Chobanian,George L. Bakris,Henry R. Black,William C. Cushman,Lee A. Green,Joseph L. Izzo,Daniel W. Jones,Barry J. Materson,Suzanne Oparil,J.T. Wright,J. R. Toccella,Edward J. Rocella,Melissa M. Brown +12 more
TL;DR: The most effective therapy prescribed by the most careful clinician will control hypertension only if patients are motivated, and empathy builds trust and is a potent motivator.
Journal ArticleDOI
A Class of $K$-Sample Tests for Comparing the Cumulative Incidence of a Competing Risk
TL;DR: In this paper, a class of tests developed for comparing the cumulative incidence of a particular type of failure among different groups is presented. The tests are based on comparing weighted averages of the hazards of the subdistribution for the failure type of interest.
Journal ArticleDOI
Comparison of Mortality in All Patients on Dialysis, Patients on Dialysis Awaiting Transplantation, and Recipients of a First Cadaveric Transplant
Robert A. Wolfe,Valarie B. Ashby,Edgar L. Milford,Akinlolu O. Ojo,Robert E. Ettenger,Lawrence Y. Agodoa,Philip J. Held,Friedrich K. Port +7 more
TL;DR: In this paper, the authors conducted a longitudinal study of mortality in 228,552 patients who were receiving long-term dialysis for end-stage renal disease, and 46,164 were placed on a waiting list for transplantation, 23,275 of whom received a first cadaveric transplant between 1991 and 1997.