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Journal ArticleDOI

Improved Graft Survival after Renal Transplantation in the United States, 1988 to 1996

TLDR
There has been a substantial increase in short-term and long-term survival of kidney grafts from both living and cadaveric donors since 1988.
Abstract
Background The introduction of cyclosporine has resulted in improvement in the short-term outcome of renal transplantation, but its effect on the long-term survival of kidney transplants is not known. Methods We analyzed the influence of demographic characteristics (age, sex, and race), transplant-related variables (living or cadaveric donor, panel-reactive antibody titer, extent of HLA matching, and cold-ischemia time), and post-transplantation variables (presence or absence of acute rejection, delayed graft function, and therapy with mycophenolate mofetil and tacrolimus) on graft survival for all 93,934 renal transplantations performed in the United States between 1988 and 1996. A regression analysis adjusted for these variables was used to estimate the risk of graft failure within the first year and more than one year after transplantation. Results From 1988 to 1996, the one-year survival rate for grafts from living donors increased from 88.8 to 93.9 percent, and the rate for cadaveric grafts increased...

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Citations
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Journal ArticleDOI

Strategies for making more organs available for transplantation

TL;DR: Organ transplantation has evolved rapidly from the first early successes to the current widespread use of donated organs for the treatment of end-stage kidney, heart, and liver failure, with limited supplies of organs and an increasing demand for them.
Journal ArticleDOI

Therapeutic drug monitoring of immunosuppressant drugs in clinical practice

TL;DR: Current data on TDM of the following immunosuppressant drugs used in organ transplantation are summarized, and recent findings indicate that monitoring of drug levels 2 hours after dosing is a more sensitive predictor of outcome than trough (C0) monitoring.
Journal ArticleDOI

Contrasting CD25hiCD4+T cells/FOXP3 patterns in chronic rejection and operational drug-free tolerance.

TL;DR: Data show that chronic rejection is associated with a decrease in CD25hiCD4+T cells and FOXP3 transcripts, suggesting that clinically “operational tolerance” may be due to a maintained phenomenon of natural tolerance that is lacking in patients with chronic rejection.
Journal ArticleDOI

The living donor.

TL;DR: In this paper, the selection criteria for living donors, the various types of surgical approaches available, with particular reference to the laparoscopic technique, and the immediate and long-term results of these procedures are presented.
Journal ArticleDOI

Mycophenolate Mofetil Dose Reduction and the Risk of Acute Rejection after Renal Transplantation

TL;DR: The cumulative number of days with the MMF dose dropped below full dose is a significant predictor of acute rejection after renal transplantation, and Clinicians need to be aware of the rejection risk when theMMF dose is reduced and maintain close surveillance on such patients.
References
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Book ChapterDOI

Nonparametric Estimation from Incomplete Observations

TL;DR: In this article, the product-limit (PL) estimator was proposed to estimate the proportion of items in the population whose lifetimes would exceed t (in the absence of such losses), without making any assumption about the form of the function P(t).
Journal ArticleDOI

Mycophenolate mofetil for the prevention of acute rejection in primary cadaveric renal allograft recipients. U.S. Renal Transplant Mycophenolate Mofetil Study Group.

TL;DR: This study demonstrated that MMF administered at a dosage of 2 g or 3 g daily, in combination with maintenance CsA and corticosteroids as triple therapy following ATGAM® induction therapy, is more effective than an otherwise identical regimen that includes azathioprine instead of MMF in preventing acute allograft rejection in first cadaveric renal transplant patients.
Journal ArticleDOI

A comparison of tacrolimus (FK506) and cyclosporine for immunosuppression after cadaveric renal transplantation. FK506 Kidney Transplant Study Group

TL;DR: Tacrolimus is more effective than cyclosporine in preventing acute rejection in cadaveric renal allograft recipients, and significantly reduces the use of antilymphocyte antibody preparations.
Journal ArticleDOI

Risk factors for chronic rejection in renal allograft recipients.

TL;DR: In this article, the authors found that acute rejection, CsA dosage < 5 mg/kg/day at 1 year, and infection are the major risk factors for the development of chronic rejection.
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