Acute rejection is known to have a strong impact on graft survival. Many studies suggest that very low acute rates can be achieved with current immunosuppressive protocols. We wanted investigate how evolved national level in the U.S. and this has impacted survival most recent era of kidney transplantation. For purpose, we analyzed data provided by Scientific Registry Transplant Recipients regarding all adult first renal transplants between 1995 2000.We noted significant decrease overall...

Abstract. An increasing number of cadaveric kidney transplants are now performed with organs from donors who would have been deemed unsuitable in earlier times. Although good allograft outcomes obtained these marginal donor transplants, it is unclear whether recipients achieve a reduction long-term mortality as do “ideal” kidneys. Patients end-stage renal disease registered on the transplant waiting list between January 1, 1992, and June 30, 1997, were studied for risks according to three...

Background. Waiting time on dialysis has been shown to be associated with worse outcomes after living and cadaveric transplantation. To validate quantify end-stage renal disease (ESRD) as an independent risk factor for kidney transplantation, we compared the outcome of paired donor kidneys, destined patients who had ESRD more than 2 years less 6 months. Methods. We analyzed data available from U.S. Renal Data System database between 1988 1998 by Kaplan-Meier estimates Cox proportional...

We studied the phenotype of late kidney graft failure in a prospective study unselected transplant biopsies taken for clinical indications. analyzed histopathology, HLA antibodies and death-censored survival 234 consecutive from 173 patients, 6 days to 31 years posttransplant. Patients with (>1 year) frequently displayed donor-specific antibody (particularly class II) microcirculation changes, including glomerulitis, glomerulopathy, capillaritis, capillary multilayering C4d staining. Grafts...

Impressive renal allograft survival improvement between 1988 and 1995 has been described using projections of half-lives based on limited actual follow up. We aimed, now with sufficient up available to calculate real half-lives. Real calculated from Kaplan-Meier curves for the overall population as well subsets repeat transplants African Americans recipients were examined. substantially shorter than projected As a whole, have improved by about 2 years compared earlier 6 improvement. The...

Renal transplant recipients with elevated body mass index (BMI) have been shown to inferior patient survival as compared patients lower BMI. However, previous studies could not establish a link between increased BMI and decreased death censored graft survival. Obesity in nontransplant has associated hypertension, hyperlipidemia, type II diabetes, proteinuria glomerulopathy. Given this evidence it is possible that renal an may worse long term To investigate hypothesis we retrospectively...

Laser-Doppler flowmetry (LDF), a new method allowing instantaneous, continuous, and noninvasive measurements of microcirculatory blood flow in small tissue sample, was evaluated for its accuracy monitoring regional cerebral (rCBF) the cortical microcirculation after focal ischemia. Wistar spontaneously hypertensive rats (SHR, n = 19) were subjected to permanent occlusion middle common carotid arteries. Absolute rCBF sample ischemic hemisphere measured autoradiographically with [ 14...

The field of transplantation has made tremendous progress since the first successful kidney transplant in 1954.To determine survival benefit solid-organ as recorded during a 25-year study period United Network for Organ Sharing (UNOS) database and Social Security Administration Death Master File.In this retrospective analysis UNOS data (September 1, 1987, through December 31, 2012), we reviewed records 1,112,835 patients: 533,329 recipients who underwent 579 506 patients were placed on...

The multiple‐matrix item sampling designs that provide information about population characteristics most efficiently administer too few responses to students estimate their proficiencies individually. Marginal estimation procedures, which directly from responses, must be employed realize the benefits of such a design. Numerical approximations appropriate marginal procedures for broad variety analyses can obtained by constructing, results comprehensive extensive solution, files plausible...

Despite the acceptance of living-donor liver transplant (LDLT) as a lifesaving procedure for end-stage disease, it remains underused in United States. Quantification lifetime survival benefit and Model End-stage Liver Disease incorporating sodium levels (MELD-Na) score range at which outweighs risk LDLT is necessary to demonstrate its safety effectiveness.To assess benefit, life-years saved, MELD-Na that was obtained individuals who received an compared with remained on wait list.This...

Background. Simultaneous pancreas-kidney transplantation (SPK) ameliorates the progression of microvascular diabetic complications but procedure is associated with excess initial morbidity and an uncertain effect on patient survival when compared solitary cadaveric or living donor renal transplantation. We evaluated mortality risks SPK, transplantation, dialysis treatment in a national cohort type 1 diabetics end-stage nephropathy. Methods. A total 13,467 adult-type enrolled renal-pancreas...

Chronic kidney disease is thought to be a potential risk factor for cardiovascular death. In renal-allograft recipients, the most significant cause of The purpose this study was investigate if renal function has role in determining death recipients.We analyzed 58,900 adult patients registered United States Renal Data System who received primary transplant between 1988 and 1998 had at least 1 year graft survival. endpoint from event beyond transplantation. Secondary endpoints were caused by...

We investigated the temporal threshold for focal cerebral infarction in spontaneously hypertensive rat. The right middle artery and common carotid were occluded 0, 1, 2, 3, 4, or 24 hours, all animals sacrificed hours after onset of ischemia. Cortical infarct volumes edema quantified serial frozen sections hematoxylin eosin-stained tissue using image analysis. Upon occlusion, blood flow core ischemic zone, measured with laser-Doppler flowmetry, fell to a mean +/- standard deviation 21 7%...

Abstract. Both transplant and dialysis outcomes have improved over recent years. In addition, transplantation has been shown to confer a survival benefit maintenance dialysis. The study presented here addresses the question of whether changed in most eras. This was based on data collected by United States Renal Transplant Scientific Registry Data System. sample consisted 104,000 patients placed renal waiting list between 1988 1996, which 73,707 subsequently received transplants. annualized...

With the shortage of deceased donor kidneys and superior clinical outcomes possible with live kidney transplantation (LDKT), more patients should seriously consider LDKT. However, little is known about how best to educate their family members We evaluated effectiveness a home-based (HB) educational program in increasing Patients were randomized clinic-based (CB) education alone (CB, n = 69) or CB plus HB (CB+HB, 63). Compared CB, CB+HB group had living inquiries (63.8% vs. 82.5%, p 0.019)...

Microarrays offer potential for objective diagnosis and insights into pathogenesis of allograft rejection. We used mouse transplants to annotate pathogenesis-based transcript sets (PBTs) that reflect major biologic events in rejection—cytotoxic T-cell infiltration, interferon-γ effects parenchymal deterioration. examined the relationship between PBT expression, histopathologic lesions clinical diagnoses 143 consecutive human kidney transplant biopsies cause. PBTs correlated strongly with one...

Kidney transplant recipients that develop signs of renal dysfunction or proteinuria one more years after transplantation are at considerable risk for progression to failure. To assess the kidney this time, a "for-cause" biopsy is performed, but provides little indication as which will go on organ In an attempt identify molecules could provide information, we used microarrays analyze gene expression in 105 for-cause biopsies taken between 1 and 31 transplantation. Using supervised principal...