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| Predicate | Object |
|---|---|
| rdf:type | |
| lifeskim:mentions | |
| pubmed:dateCreated |
1993-8-17
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| pubmed:abstractText |
Based upon analyses of 40,671 kidney transplants reported to the UNOS Scientific Renal Transplant Registry between October 1987 and August 1992: 1. Twenty-four percent of the 21,923 recipients of first cadaver grafts experienced one or more rejection episodes during their transplant hospitalization, 52% during the first 6 months. At 12 months, only 40% of patients remained rejection-free. Patients who experienced any rejection during the first 6 months had a 72% 1-year graft survival rate compared with 95% for those who remained rejection-free (p < 0.001). 2. Recipients of transplants from living donors had a significantly lower incidence of rejection episodes. There was a clear effect of histocompatibility in comparing the incidence of rejection in HLA-identical sibling transplants (8% at discharge and 32% at 1 year) with that in 1-haplotype disparate transplants (22% at discharge and 52% at 1 year, p < 0.01 at each time point). Rejections were reported for 25% of transplants from other living donors at discharge and for 56% at 1 year, similar to the figures for cadaver transplants. 3. Histocompatibility also influenced the incidence of rejection in first cadaver-donor transplants. Only 15% of recipients of 0-HLA-A,B mismatched kidneys had rejection episodes reported at discharge, compared with 26% of those who received kidneys completely mismatched for HLA-A,B antigens (p < 0.01). At 1 year, 56% of HLA-A,B matched patients remained rejection-free, whereas only 35% of those mismatched for 4 antigens had no reported rejection through the first year (p < 0.01). Considering HLA-DR antigen mismatches, 19% of the 0-antigen mismatched group had rejection episodes at discharge, versus 28% for those with 2 HLA-DR mismatches (p < 0.01), and at 1 year, the percentage who were rejection-free decreased from 48% to 40% and 34% with 0, 1, and 2 HLA-DR mismatches, respectively. 4. The incidence of rejection episodes decreased as the recipient's age increased. Patients under age 16 had the highest incidence prior to discharge (28%) and at 1 year (70%) compared with 17% and 47% at the same intervals in patients over age 60 (p < 0.01). 5. The donor's age also had a significant effect on rejection episodes. Transplants from pediatric and older donors had a higher incidence of reported rejections than those from donors aged 16-30, especially after hospital discharge.(ABSTRACT TRUNCATED AT 400 WORDS)
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| pubmed:language |
eng
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| pubmed:journal | |
| pubmed:citationSubset |
IM
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| pubmed:chemical | |
| pubmed:status |
MEDLINE
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| pubmed:issn |
0890-9016
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| pubmed:author | |
| pubmed:issnType |
Print
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| pubmed:owner |
NLM
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| pubmed:authorsComplete |
Y
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| pubmed:pagination |
391-404
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| pubmed:dateRevised |
2004-11-17
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| pubmed:meshHeading |
pubmed-meshheading:1306715-Adolescent,
pubmed-meshheading:1306715-Adult,
pubmed-meshheading:1306715-Child,
pubmed-meshheading:1306715-Child, Preschool,
pubmed-meshheading:1306715-Creatinine,
pubmed-meshheading:1306715-Graft Rejection,
pubmed-meshheading:1306715-Graft Survival,
pubmed-meshheading:1306715-HLA Antigens,
pubmed-meshheading:1306715-Humans,
pubmed-meshheading:1306715-Infant,
pubmed-meshheading:1306715-Infant, Newborn,
pubmed-meshheading:1306715-Kidney Diseases,
pubmed-meshheading:1306715-Kidney Transplantation,
pubmed-meshheading:1306715-Middle Aged,
pubmed-meshheading:1306715-Registries,
pubmed-meshheading:1306715-Risk Factors,
pubmed-meshheading:1306715-Survival Rate,
pubmed-meshheading:1306715-Time Factors,
pubmed-meshheading:1306715-United States
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| pubmed:year |
1992
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| pubmed:articleTitle |
Rejection episodes.
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| pubmed:publicationType |
Journal Article
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