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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

Prediction of acute cellular renal allograft rejection by urinary metabolomics using MALDI-FTMS.

TL;DR: The combination of MALDI-FTMS technology with a clear definition of patient groups can detect urine small molecule associated with ACR, andKidney transplant patients withACR could be distinguished from those without ACR using four individual small molecules with a specificity of 100%.
Journal ArticleDOI

Risk prediction models for graft failure in kidney transplantation: a systematic review.

TL;DR: The study highlights the need to better account for competing risks when applicable in such studies, and to adequately account for post‐transplant measures of predictors in studies aiming at improving monitoring of kidney transplant recipients.
Journal ArticleDOI

Risk factors for chronic transplant dysfunction and cardiovascular disease are related to accumulation of advanced glycation end-products in renal transplant recipients

TL;DR: Skin-autofluorescence was associated with several risk factors for cardiovascular disease and chronic renal transplant dysfunction, in line with the hypothesis that AGEs play a role in the pathogenesis of these conditions in renal transplant recipients.
Journal ArticleDOI

Early Withdrawal of Calcineurin Inhibitors and Rescue Immunosuppression with Sirolimus‐Based Therapy in Renal Transplant Recipients with Moderate to Severe Renal Dysfunction

TL;DR: The salutary effects of sirolimus therapy following discontinuation of tacrolimus in patients with moderate to severe graft dysfunction due to allograft nephropathy even in high‐risk patients improves kidney function and prevents acute rejection.
Journal ArticleDOI

Toxicodynamic therapeutic drug monitoring of immunosuppressants: promises, reality, and challenges.

TL;DR: A series of studies in rats and healthy individuals evaluating the effects of immunosuppressant-induced changes of metabolite patterns in urine were associated with a combination of changes in glomerular filtration, changes in secretion/absorption by tubulus cells, and changes in kidney cell metabolism.
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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