Clinical transplants最新文献_第10页

Immunoglobulin G subclass analysis of HLA donor specific antibodies in heart and renal transplant recipients. 心脏和肾脏移植受者HLA供者特异性抗体的免疫球蛋白G亚类分析。

Clinical transplants Pub Date : 2013-01-01

James C Cicciarelli, Noriyuki Kasahara, Nathan A Lemp, Robert Adamson, Walter Dembitsky, Barry Browne, Steven Steinberg

{"title":"Immunoglobulin G subclass analysis of HLA donor specific antibodies in heart and renal transplant recipients.","authors":"James C Cicciarelli, Noriyuki Kasahara, Nathan A Lemp, Robert Adamson, Walter Dembitsky, Barry Browne, Steven Steinberg","doi":"","DOIUrl":"","url":null,"abstract":"Immunoglobulin G (IgG) subclasses IgG1 (G1) and lgG3 (G3) can induce complement dependent cytotoxicity (CDC) and bind to Fc receptors (FcR), which induces phagocytosis and antibody dependent cellular cytotoxicity. In contrast, IgG2 has low CDC activity, lgG4 (G4) has no CDC activity, and neither binds high affinity FcR. Seven transplant recipients were analyzed for G1- G4 human leukocyte antigen (HLA) donor-specific antibodies (DSAs); six had active rejection and one had stable function. Patients with rejection had equal numbers of DSAs, which were G1 and G3, but no G4. The predominant DSAs were directed against HLA Class II proteins. Even with successful anti-rejection therapy, DSA persisted, albeit in several instances with lowered levels. Our findings are consistent with the presence of CDC-inducing G1 and G3 subclass DSAs during rejection. One heart transplant recipient followed for over 42 months had consistent, continuous G4 HLA DSA and stable function. We hypothesize that the presence of G4 DSA in the heart transplant recipient is akin to the allergen specific G4 that has been found in allergic desensitization tolerance, controlled by regulatory T-cells, and that manipulating G4 class switching through HLA antigen desensitzation could produce a tolerant state.","PeriodicalId":77074,"journal":{"name":"Clinical transplants","volume":" ","pages":"413-22"},"PeriodicalIF":0.0,"publicationDate":"2013-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"32562702","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Causes of graft failure in simultaneous pancreas-kidney transplantation by various time periods. 不同时期胰肾联合移植中移植物衰竭的原因。

Clinical transplants Pub Date : 2013-01-01

Kayo Wakil, Yasuhiko Sugawara, Norihiro Kokudo, Takashi Kadowaki

{"title":"Causes of graft failure in simultaneous pancreas-kidney transplantation by various time periods.","authors":"Kayo Wakil, Yasuhiko Sugawara, Norihiro Kokudo, Takashi Kadowaki","doi":"","DOIUrl":"","url":null,"abstract":"Data collected by the United Network for Organ Sharing from all approved United States transplant programs was analyzed. The data included 26,572 adult diabetic patients who received a primary pancreas transplant between January 1987 and December 2012. Simultaneous pancreas-kidney (SPK) transplantation was the major therapeutic option for diabetes patients. SPK had better graft survival than pancreas transplant alone (PTA) or pancreas-after-kidney (PAK) or pancreas-with-kidney (from a living donor, PWK). The 5-year pancreas graft survival rates for SPK, PWK, PAK, and PTA were 70.0%, 57.2%, 54.0%, and 48.2%, respectively. When long-term SPK pancreas graft survival was examined by various transplant time periods, it was found that survival has remained almost stable since 1996. Graft survival rates were high among the pancreas recipients transplanted in the periods 1996-2000, 2001-2005, and 2006-2012, and the rates were similar: the 5-year rates were 68.9%, 72.4%, and 73.8%, respectively. Technical failure was the leading cause of graft loss during the first year post-transplant, regardless of period: 61.3%, 68.6%, 64.2%, and 71.9% for 1987-1995, 1996-2000, 2001-2005, and 2006-2012, respectively. After one year, chronic rejection was the leading cause of graft loss in all periods: 51.8%, 53.2%, 44.3%, and 40.7% for 1987-1995, 1996-2000, 2001-2005, and 2006-2012, respectively. Chronic rejection accounted for around 50% (or more) of the grafts that survived over five years. Survival of long-term pancreas grafts as well as long-term causes of graft loss remained almost unchanged across the different transplant periods. Clearly, there is a need for a means to identify early markers of chronic rejection, and to control it to improve long-term survival.","PeriodicalId":77074,"journal":{"name":"Clinical transplants","volume":" ","pages":"23-30"},"PeriodicalIF":0.0,"publicationDate":"2013-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"32560983","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

2013 report from the Center for International Blood and Marrow Transplant Research (CIBMTR): current uses and outcomes of hematopoietic cell transplants for blood and bone marrow disorders. 2013年国际血液和骨髓移植研究中心(CIBMTR)的报告:造血细胞移植治疗血液和骨髓疾病的当前用途和结果。

Clinical transplants Pub Date : 2013-01-01

Marcelo Pasquini, Zhiwei Wang, Mary M Horowitz, Robert Peter Gale

引用次数: 0

A regulated system of incentives for living kidney donation: why can't we agree to do a trial? 活体肾脏捐赠的激励机制:为什么我们不能同意进行试验?

Clinical transplants Pub Date : 2013-01-01

Arthur J Matas

引用次数: 0

A common blood gene assay predates clinical and histological rejection in kidney and heart allografts. 一种常见的血液基因测定在肾脏和心脏同种异体移植的临床和组织学排斥之前。

Clinical transplants Pub Date : 2013-01-01

Minnie Sarwal, Tara Sigdel

{"title":"A common blood gene assay predates clinical and histological rejection in kidney and heart allografts.","authors":"Minnie Sarwal, Tara Sigdel","doi":"","DOIUrl":"","url":null,"abstract":"We assayed our recently defined blood gene panel, diagnostic for kidney and cardiac acute rejection (AR), for its ability to predict biopsy-confirmed renal and cardiac AR prior to clinical or histological AR detection. We utilized a subset of 63 patients from our recent studies with biopsy-confirmed AR (n=40 kidney AR, n=23 cardiacAR) who had paired blood samples collected within 6 months before and after AR. Blood samples were analyzed by quantitative polymerase chain reaction (QPCR) for 10 genes, modeled across differing panels of 5 genes for kidney and heart AR to classify each sample with a quantitative prediction score for rejection. The performance accuracy of the 5-gene panels for AR were compared to the only commercially available QPCR blood assay (AlloMap). A blood gene-based molecular call for AR was made -3 months prior to the histological AR diagnosis in both kidney (92% predicted probability) and cardiac (80% predicted probability) transplant patients and outperformed the AlloMapTM blood test for accuracy and sensitivity [area under the curve (AUC)=0.917 for the kidney 5 genes and 0.915 for the cardiac 5 genes versus an AUC=0.72 for AlloMap]. Serial, posttransplant, targeted profiling of blood samples for a set of 10 genes provides a means to identify kidney and heart transplant recipients at high risk for graft dysfunction and, in the absence of immunosuppression customization, fated to advance to histological rejection and increased graft and patient morbidity.","PeriodicalId":77074,"journal":{"name":"Clinical transplants","volume":" ","pages":"241-7"},"PeriodicalIF":0.0,"publicationDate":"2013-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"32561815","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Fifteen years later: main lessons from composite tissue allografts. 15年后:同种异体复合组织移植的主要经验教训。

Clinical transplants Pub Date : 2013-01-01

Jean-Michel Dubernard, Angela Sirigu, Christian Seulin, Emmanuel Morelon, Palmina Petruzzo

{"title":"Fifteen years later: main lessons from composite tissue allografts.","authors":"Jean-Michel Dubernard, Angela Sirigu, Christian Seulin, Emmanuel Morelon, Palmina Petruzzo","doi":"","DOIUrl":"","url":null,"abstract":"Composite tissue allografts (CTA) are also called \"reconstructive transplantation\" as they are a valid alternative approach to repairing complex tissue defects. These procedures are still considered \"experimental\" and their therapeutic value remains to be validated. An immunosuppressive treatment similar to that used in solid organ transplantation allows CTA survival and function despite a high rate of acute rejection (AR) episodes. Clinical experience seems to confirm that skin is the most antigenic tissue and the first target of AR episodes, which are easy to reverse and do not seem to adversely influence graft survival and function when promptly treated. Chronic rejection can also occur in CTA, although its features are still unclear. Upper-extremity or face-transplanted patients show a relevant sensorimotor recovery. Patients are able to perform the majority of daily activities and to lead normal social lives. Global cortical remodeling occurs in the months following transplantation, reversing the functional reorganization induced by the amputation. Appropriation of the graft occurs in parallel with functional recovery. The patients' compliance is essential for the success of CTAs as well as careful recipient selection and patient follow-up to prevent complications of long-term immunosuppression.","PeriodicalId":77074,"journal":{"name":"Clinical transplants","volume":" ","pages":"113-9"},"PeriodicalIF":0.0,"publicationDate":"2013-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"32561848","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Statins in heart transplantation. 他汀类药物在心脏移植中的应用

Clinical transplants Pub Date : 2013-01-01

Michelle M Kittleson, Jon A Kobashigawa

{"title":"Statins in heart transplantation.","authors":"Michelle M Kittleson, Jon A Kobashigawa","doi":"","DOIUrl":"","url":null,"abstract":"Over the last four decades, cardiac transplantation has become the preferred therapy for select patients with end-stage heart disease. Critical to the success of heart transplantation are the continual investigational efforts to optimize immunosuppressive regimens. One of the major advances over the past few decades has been the use of 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitors (commonly referred to as statins) to reduce the risk of rejection and allograft vasculopathy in heart transplant recipients. This chapter will focus on the advances of statin therapy in the management of heart transplant recipients. Statins are widely used for the primary and secondary prevention of atherosclerotic cardiovascular disease and the benefit is derived not only from lipid lowering, but also through the pleiotropic, cholesterol-independent effects, which include vasculoprotective, antiinflammatory, and immunosuppressive properties. Statin therapy administered to patients after heart transplantation results in a decrease in rejection, cardiac allograft vasculopathy, and an increase in short- and long-term survival. Statins can be considered a feat of translational medicine, where the mechanistic analysis of potential benefit has been realized in an improvement in the quality and quantity of life of heart transplant recipients.","PeriodicalId":77074,"journal":{"name":"Clinical transplants","volume":" ","pages":"135-43"},"PeriodicalIF":0.0,"publicationDate":"2013-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"32561851","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

HLA in anthropology: the enigma of Easter Island. 人类白细胞抗原在人类学:复活节岛之谜。

Clinical transplants Pub Date : 2013-01-01

Alicia Sanchez-Mazas, Erik Thorsby

引用次数: 0

Transplantation in Turkey. 土耳其的器官移植。

Clinical transplants Pub Date : 2013-01-01

Mehmet Haberal

{"title":"Transplantation in Turkey.","authors":"Mehmet Haberal","doi":"","DOIUrl":"","url":null,"abstract":"The cornerstone events of transplantation history in Turkey are summarized herein. In 1975, we performed the first living-related renal transplant in Turkey. We followed this in 1978 with the first deceased donor kidney transplantation, using an organ supplied by Eurotransplant. In 1979, the law on harvesting, storage, grafting, and transplantation of organs and tissues was enacted; later that year, the first local deceased donor kidney transplantation was performed by our team. In 1988, another groundbreaking event in Turkey was successfully achieved: the first cadaveric liver transplantation. In 1990, the first pediatric living-related segmental liver transplantation in Turkey, the region, and Europe was performed by our team. One month later, an adult-to-adult living-related liver transplantation was successfully performed. In May 1992, we performed the first combined liver-kidney transplantation from a living-related donor, which was the first operation of its kind. To date, we have performed 2,084 kidney and, since 1988, 439 liver transplantations. During 29 years of solid organ transplantation history in Turkey, 20,794 kidney transplants have been performed nationwide in 62 different centers, as well as 6,565 liver, 621 heart, and 168 pancreas transplants. In 2001, the Ministry of Health established the National Coordination Center as an umbrella organization to promote transplantation activities, especially for deceased donor organ procurement. Transplantation activities are accelerating daily throughout the country, but deceased donors are still far below the desired rates.","PeriodicalId":77074,"journal":{"name":"Clinical transplants","volume":" ","pages":"175-80"},"PeriodicalIF":0.0,"publicationDate":"2013-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"32561855","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Evolution of studies of HLA class I antigen processing machinery (APM) components in malignant cells. 恶性细胞HLA I类抗原加工机制(APM)成分的研究进展。

Clinical transplants Pub Date : 2013-01-01

Francesco Sabbatino, Joseph H Schwab, Soldano Ferrone, Cristina R Ferrone

引用次数: 0