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Predicate | Object |
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rdf:type | |
lifeskim:mentions | |
pubmed:issue |
5
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pubmed:dateCreated |
1993-6-21
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pubmed:abstractText |
The causes of failure were studied for 1386 cadaver kidney transplants shared through the UNOS 6-antigen match program from November 1987 to February 1992. The one-year graft survival for 1004 HLA-matched first cadaver transplants was 88% compared with 90% for parent donor and 78% for 22,188 HLA-mismatched first cadaveric donors reported to the UNOS Scientific Renal Transplant Registry. The cause of graft loss was immunological in 55% of HLA-mismatched cadaver kidney failures, whereas only 39% of the HLA-matched graft failures were immunological. The fraction of immunological failures in HLA-matched first transplant recipients younger than age 17 was 57% and decreased with increasing age to 14% for recipients older than age 60. Death with a functioning graft accounted for 50% of failures in the older age group. Sensitization was associated with an increased incidence of immunological failures in matched first graft recipients from 36% in nonsensitized to 53% in broadly sensitized patients, and 55% of failures were immunological in second graft recipients compared with 39% in first transplants. Some immunological failures may have been due to tissue typing, since only 18% of failures in kidneys with well-defined HLA antigens were immunological, whereas 44% of kidneys matched with more difficult HLA antigens were lost due to immunological causes. The results indicate that phenotypically identical cadaver renal transplants have a reduced rate of immunological failures. As the accuracy of this tissue typing for the more difficult HLA antigens improves, immunological failures in this group of transplants will decline even further.
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pubmed:grant | |
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:month |
May
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pubmed:issn |
0041-1337
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pubmed:author | |
pubmed:issnType |
Print
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pubmed:volume |
55
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pubmed:owner |
NLM
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pubmed:authorsComplete |
Y
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pubmed:pagination |
1005-8
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pubmed:dateRevised |
2007-11-14
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pubmed:meshHeading |
pubmed-meshheading:8497872-Adolescent,
pubmed-meshheading:8497872-Adult,
pubmed-meshheading:8497872-Aged,
pubmed-meshheading:8497872-Cadaver,
pubmed-meshheading:8497872-Graft Rejection,
pubmed-meshheading:8497872-Graft Survival,
pubmed-meshheading:8497872-HLA Antigens,
pubmed-meshheading:8497872-Histocompatibility Testing,
pubmed-meshheading:8497872-Humans,
pubmed-meshheading:8497872-Immunization,
pubmed-meshheading:8497872-Kidney Transplantation,
pubmed-meshheading:8497872-Middle Aged,
pubmed-meshheading:8497872-Survival Analysis,
pubmed-meshheading:8497872-Time Factors,
pubmed-meshheading:8497872-Treatment Outcome
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pubmed:year |
1993
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pubmed:articleTitle |
Six-antigen-matched transplants. Causes of failure.
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pubmed:affiliation |
Tissue Typing Laboratory, University of California, Los Angeles 90024.
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pubmed:publicationType |
Journal Article,
Research Support, U.S. Gov't, P.H.S.
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