Linked Life Data

20074463

Source:http://linkedlifedata.com/resource/pubmed/id/20074463

Statements in which the resource exists as a subject.
PredicateObject
rdf:type
lifeskim:mentions
pubmed:issue
4
pubmed:dateCreated
2010-1-15
pubmed:abstractText
Features of acute rejection in dual kidney transplant have not been studied. The aim of this study is to compare acute rejections in dual kidney transplant recipients from elderly donors on different immunosuppressive protocols. Sixty-nine patients were evaluated: 28 received calcineurin inhibitor-based (group 1) and 41 received calcineurin inhibitor-free immunosuppression (group 2). Histology of all donor kidneys was evaluated before implantation. All rejections showed tubulitis in both groups, and were classified as T-cell mediated acute rejections. Incidence and Banff grade of rejections in the two groups were not significantly different. Late rejections however, were observed in group 1 (P < 0.01) whereas steroid-resistant rejections occurred in group 2 (P < 0.03). C4d deposition was only observed in group 2. Occurrence of acute rejection was significantly associated with graft loss due to interstitial fibrosis/tubular atrophy in both groups. In group 1 mean serum creatinine levels of patients with rejections at six months and one year were higher than those of patients without rejections (P < 0.03 and P < 0.009, respectively). In group 2 they were higher at six months (P < 0.01) but not at one year. In addition, graft loss due to interstitial fibrosis/tubular atrophy occurred in 3/28 patients in group 1 (10.7%, OR= 1.95, 95%CI 1.02-3.71), and in 1/41 patients in group 2 (2.4%, OR= 0.41, 95%CI 0.07-2.24). Taken together these results suggest better renal function in patients on calcineurin inhibitor-free immunosuppression. In conclusion, acute rejections were detrimental irrespective of the type of immunosuppression, but different features were observed with each therapy. A tailored approach should be advantageous for prevention and treatment of acute rejections.
pubmed:language
eng
pubmed:journal
pubmed:citationSubset
IM
pubmed:chemical
pubmed:status
MEDLINE
pubmed:issn
0394-6320
pubmed:author
pubmed:issnType
Print
pubmed:volume
22
pubmed:owner
NLM
pubmed:authorsComplete
Y
pubmed:pagination
1001-7
pubmed:meshHeading
pubmed-meshheading:20074463-Acute Disease, pubmed-meshheading:20074463-Age Factors, pubmed-meshheading:20074463-Aged, pubmed-meshheading:20074463-Biological Markers, pubmed-meshheading:20074463-Biopsy, pubmed-meshheading:20074463-Calcineurin, pubmed-meshheading:20074463-Complement C4b, pubmed-meshheading:20074463-Creatinine, pubmed-meshheading:20074463-Drug Therapy, Combination, pubmed-meshheading:20074463-Female, pubmed-meshheading:20074463-Graft Rejection, pubmed-meshheading:20074463-Graft Survival, pubmed-meshheading:20074463-Humans, pubmed-meshheading:20074463-Immunosuppressive Agents, pubmed-meshheading:20074463-Kidney Transplantation, pubmed-meshheading:20074463-Male, pubmed-meshheading:20074463-Middle Aged, pubmed-meshheading:20074463-Odds Ratio, pubmed-meshheading:20074463-Peptide Fragments, pubmed-meshheading:20074463-Severity of Illness Index, pubmed-meshheading:20074463-Time Factors, pubmed-meshheading:20074463-Tissue Donors, pubmed-meshheading:20074463-Treatment Outcome
pubmed:articleTitle
Acute rejection features in dual kidney transplant recipients from elderly donors: comparison of calcineurin inhibitor-based and calcineurin inhibitor-free immunosuppressive protocols.
pubmed:affiliation
Dept. of Oncology and Neurosciences, University of Chieti, Italy.
pubmed:publicationType
Journal Article, Comparative Study