دورية أكاديمية
Prognostic factors for renal transplant graft survival in a retrospective cohort of 1000 cases: The role of desensitization therapy.
| العنوان: | Prognostic factors for renal transplant graft survival in a retrospective cohort of 1000 cases: The role of desensitization therapy. |
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| المؤلفون: | Lee CY; Department of Surgery, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan., Yang CY; Department of Surgery, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan., Lin WC; Department of Pathology, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan., Chen CC; Department of Surgery, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan., Tsai MK; Department of Surgery, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan; Department of Surgery, National Taiwan University Hospital, Hsin-Chu Branch, Hsin-Chu City, Taiwan. Electronic address: mengkuntsai@ntu.edu.tw. |
| المصدر: | Journal of the Formosan Medical Association = Taiwan yi zhi [J Formos Med Assoc] 2020 Apr; Vol. 119 (4), pp. 829-837. Date of Electronic Publication: 2019 Dec 06. |
| نوع المنشور: | Journal Article |
| اللغة: | English |
| بيانات الدورية: | Publisher: Formosan Medical Association, Elsevier Country of Publication: Singapore NLM ID: 9214933 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 0929-6646 (Print) Linking ISSN: 09296646 NLM ISO Abbreviation: J Formos Med Assoc Subsets: MEDLINE |
| أسماء مطبوعة: | Publication: 2003- : Singapore : Formosan Medical Association, Elsevier Original Publication: Taipei, Taiwan : Formosan Medical Association, [1991- |
| مواضيع طبية MeSH: | Graft Survival* , Living Donors*, ABO Blood-Group System/*immunology , HLA Antigens/*immunology , Kidney Transplantation/*mortality, Adult ; Female ; Graft Rejection ; Humans ; Male ; Middle Aged ; Prognosis ; Retrospective Studies ; Survival Analysis ; Survival Rate ; Taiwan |
| مستخلص: | Background: To review the results of renal transplantation after promulgation of the Human Organ Transplant Act in Taiwan in 1987, we conducted a retrospective study in the first 1000 cases performed in our hospital. Prognostic factors for graft survival were assessed with emphasis on the impact of donor-specific antibody (DSA). Methods: Between January 1988 and April 2014, there were 1000 cases of renal transplantation performed in our hospital. Excluding 30 patients of ABO-incompatible transplantation, we reviewed 970 cases of ABO-compatible renal transplantation to analyze the prognostic factors for graft survival. The patients were grouped according to the dates of operations before (the Early group: 503 cases) and after (the Late group: 467 cases) the introduction of detection and desensitization of alloantibody in our hospital in 2004. Results: The overall 5-year graft survival rate were 82.6%, which was significantly lower in the Early group (79.2%) than the Late group (86.3%) (p = 0.0012). The 1-year rejection-free survival was significantly lower in the Early group (78.3%) than the Late group (91.2%) (p = 0.0165). The difference between the two groups became insignificant when the time of observation extended beyond 12 months. In a multivariate regression model, we identified significant factors for poor graft survival, including HLA mismatches, delayed graft function with or without recovery, and antibody-mediate rejection (AMR). Conclusion: HLA mismatches, delayed graft function with or without recovery, and AMR were significant factors for poor graft survival. Detection and desensitization of DSA currently might be inadequate to improve the long-term outcome of renal transplantation. Competing Interests: Declaration of Competing Interest The authors have no conflicts of interest relevant to this article. (Copyright © 2019. Published by Elsevier B.V.) |
| فهرسة مساهمة: | Keywords: Graft survival; Kidney transplantation; Prognostic factor |
| المشرفين على المادة: | 0 (ABO Blood-Group System) 0 (HLA Antigens) |
| تواريخ الأحداث: | Date Created: 20191211 Date Completed: 20210120 Latest Revision: 20210120 |
| رمز التحديث: | 20240628 |
| DOI: | 10.1016/j.jfma.2019.11.008 |
| PMID: | 31818714 |
| قاعدة البيانات: | MEDLINE |
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Full Text Finder | تدمد: | 0929-6646 |
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| DOI: | 10.1016/j.jfma.2019.11.008 |