Nephrol Dial Transplant
Division of Internal Medicine, University of Florida College of Medicine, Gainesville, FL, USA.
Published: November 2004
Background: Mycophenolate mofetil (MMF) has been shown to decrease acute rejection episodes after kidney transplantation, and has been associated with better graft and patient survival vs azathioprine (AZA). Previous studies reported a higher risk of death due to infection in elderly recipients treated with MMF-based immunosuppression.
Methods: We analysed 5069 elderly ( > 65 years of age) primary renal allograft recipients treated with either MMF or AZA reported to the Scientific Registry of Transplant Recipients between 1988 and 2000, and compared rates of acute rejection, late acute rejection, graft survival, death-censored graft survival, patient survival and death with a functioning graft.
Results: In Cox proportional hazard models, MMF was associated with lower rates of late acute rejection with 12 (RR = 0.72, P = 0.11) and 24 months (RR = 0.50, P = 0.028) of continuous therapy. In univariate analysis (Kaplan-Meier), MMF was associated with improved patient (P = 0.0003) and graft (P<0.0001) survival vs AZA, and trends toward improved patient and graft survival in multivariate analyses.
Conclusions: These findings demonstrate the efficacy of MMF-based immunosuppression in elderly transplant recipients and do not suggest an increased risk of death compared to treatment with AZA.
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http://dx.doi.org/10.1093/ndt/gfh445 | DOI Listing |
Narra J
December 2024
Division of Nephrology and Hypertension, Department of Internal Medicine, Faculty of Medicine, Universitas Brawijaya, Malang, Indonesia.
Transplant renal artery stenosis (TRAS) is a serious complication of renal transplantation, with its prevalence and associated factors remaining inconclusive. The aim of this study was to assess the global prevalence and risk factors associated with TRAS incidence in renal transplant recipients. We conducted a meta-analysis by collecting data on the prevalence and factors associated with TRAS from articles in Scopus, Embase, and PubMed.
View Article and Find Full Text PDFIntern Med J
January 2025
Nephrology and Transplantation Department, John Hunter Hospital, Newcastle, New South Wales, Australia.
Background: Smoking has been shown to have detrimental effects on KT outcomes and survival. Most units and guidelines advocate for the cessation of smoking prior to a kidney transplant and consider it a general contraindication to listing. Smoking prevalence is higher in disadvantaged groups.
View Article and Find Full Text PDFWorld J Gastroenterol
January 2025
Senior Department of Hematology, The Fifth Medical Center of PLA General Hospital, Beijing 100071, China.
In this article, we comment on an article published in a recent issue of the . We specifically focus on the roles of human leukocyte antigen (HLA) and donor-specific antibodies (DSAs) in pediatric liver transplantation (LT), as well as the relationship between immune rejection after LT and DSA. Currently, LT remains the standard of care for pediatric patients with end-stage liver disease or severe acute liver failure.
View Article and Find Full Text PDFExp Clin Transplant
December 2024
>From the Department of Pathology, Imam Reza Hospital, Mashhad University of Medical Sciences, Mashhad, Iran.
Objectives: Liver transplant is the most effective therapeutic option for patients with end-stage liver disease, nonalcoholic steatohepatitis, and acute liver failure. We evaluated whether the percentage of hepatic fat percentage affected transplant outcomes to determine whether livers with varying severity of macrosteatosis should be considered suitable for donation.
Materials And Methods: We analyzed data from 381 patients with liver failure who received liver transplant at Montaseriyeh Hospital in Mashhad, Iran, between 2013 and 2022.
Medicine (Baltimore)
November 2024
Department of Urology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China.
Acute rejection (AR) is a common complication in the early stage after kidney transplantation. Some studies have shown that the occurrence of AR after kidney transplantation may further affect the development of tumors, and both AR and tumor development are related to immune cells and immune genes, so it is particularly important to diagnose the occurrence of AR at an early stage and to analyze the correlation between AR and tumors. In this study, we applied bioinformatics techniques for differential expression analysis and weighted gene co-expression network analysis analysis of AR patients to obtain differentially expressed genes and modular genes significantly associated with AR, respectively, so as to obtain their intersecting genes with immune-related genes; 21 intersecting genes were screened by lasso regression and Boruta algorithm to obtain the genes, and finally, the feature genes that were significantly associated with the dependent variable were further obtained by single-factor and multi-factor logistic regression.
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