The Experts below are selected from a list of 3756 Experts worldwide ranked by ideXlab platform
Guanrong Chen - One of the best experts on this subject based on the ideXlab platform.
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complement inhibition enables renal allograft accommodation and long term engraftment in presensitized nonhuman primates
American Journal of Transplantation, 2011Co-Authors: Song Chen, Shan Zhong, Ying Xiang, Hui Guo, Wan-yu Wang, Yuliang Xiong, Guanrong Chen, X P ChenAbstract:Protection against humoral injury mediated by donor-specific antibodies (DSA), also known as accommodation, may allow for long-term allograft survival in presensitized recipients. In the present study, we determined the role of complement in renal allograft accommodation in donor skin-presensitized nonhuman primates under conventional immunosuppression. Donor skin allografts were transplanted to presensitized recipients 14 days prior to renal Transplantation. Renal allografts not receiving any immunosuppressive treatment developed accelerated rejection with predominantly humoral injury, which was not prevented using conventional cyclosporine (CsA) triple therapy. Inhibition of complement activation with the Yunnan-cobra venom factor (Y-CVF) successfully prevented accelerated antibody-mediated rejection and resulted in successful accommodation and long-term renal allograft survival in most presensitized recipients. Accommodation in this model was associated with the prevention of the early antibody responses induced against donor antigens by complement inhibition. Some antiapoptotic proteins and complement regulatory proteins, including Bcl-2, CD59, CD46 and clusterin, were upregulated in the surviving renal allografts. These results suggest that the complement inhibition-based strategy may be valuable alternative in future clinical cross-match positive or ABO-incompatible Transplantation.
Hiroshi Toma - One of the best experts on this subject based on the ideXlab platform.
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excellent long term outcome of abo incompatible living donor kidney Transplantation in japan
American Journal of Transplantation, 2004Co-Authors: Kota Takahashi, Kazuhide Saito, Shiro Takahara, Akihiko Okuyama, Kazunari Tanabe, Hiroshi Toma, Kazuharu Uchida, Akira Hasegawa, Norio Yoshimura, Yoriaki KamiryoAbstract:Owing to the severe shortage of cadaveric grafts in Japan, we have performed ABO-incompatible living donor kidney Transplantation since 1989. This study assessed short- and long-term outcomes in 441 patients who received ABO-incompatible living donor kidney transplants between January 1989 and December 2001. We compared our results with historical data from 1055 recipients of living kidney Transplantation. Overall patient survival rates 1, 3, 5, 7, and 9 years after ABO-incompatible Transplantation were 93%, 89%, 87%, 85%, and 84%, respectively. Corresponding overall graft survival rates were 84%, 80%, 71%, 65%, and 59%. After ABO-incompatible Transplantation, graft survival rates were significantly higher in patients 29 years or younger than in those 30 years or older and in patients who received anticoagulation therapy than in those who did not receive such therapy. There were no significant differences between A-incompatible and B-incompatible recipients with respect to clinical outcomes. The graft survival rate at 1 year in the historical controls was slightly but not significantly higher than that in our recipients of ABO-incompatible transplants. We conclude that long-term outcome in recipients of ABO-incompatible living kidneys is excellent. Transplantation of ABO-incompatible kidneys from living donors is a radical, but effective treatment for end-stage renal disease.
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time dependent risk factors influencing the long term outcome in living renal allografts donor age is a crucial risk factor for long term graft survival more than 5 years after Transplantation
Transplantation, 2001Co-Authors: Hiroshi Toma, Kazunari Tanabe, T Tokumoto, Tomokazu Shimizu, H ShimmuraAbstract:BACKGROUND: Most investigations have revealed that the improvement in early graft survival has not resulted in a corresponding improvement in long-term graft survival. The risk factors for long-term graft survival should be clarified. METHODS: A single-center experience of 1100 consecutive renal transplant recipients who received kidneys from living donors from 1983 to 1998 was reviewed to clarify the time dependency of risk factors for long-term graft survival. We examined various possible risk factors, including HLA-AB and -DR mismatches, ABO-blood group incompatibility, graft weight, donor age and sex, recipient age and sex, and the presence or absence of acute rejection by using the time-dependent, nonproportional Cox's hazards model. RESULTS: Acute rejection episode, donor age, HLA-AB 4-antigen mismatches, ABO-incompatible Transplantation, smaller kidney weight compared with the patient's body weight (Kw/Bw ratio less than 2.67), and Transplantation from an unrelated living donor were risk factors for long-term graft outcome. Multivariate analysis for time-dependent risk factors showed that donor age of more than 60 years was the most important risk factor for long-term graft failure after 5 years postTransplantation (hazard ratio: 2.57). In contrast, acute rejection, ABO incompatibility, and nonrelated donors were significant risk factors for short-term graft failure within 5 years after kidney Transplantation (hazard ratios: 2.68, 1.57, and 1.69, respectively). CONCLUSIONS: Donor age of more than 60 years was a crucial risk factor affecting long-term graft survival. In contrast, acute rejection, ABO incompatibility, and nonrelated donors were significant risk factors for short-term graft failure.
Yoriaki Kamiryo - One of the best experts on this subject based on the ideXlab platform.
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excellent long term outcome of abo incompatible living donor kidney Transplantation in japan
American Journal of Transplantation, 2004Co-Authors: Kota Takahashi, Kazuhide Saito, Shiro Takahara, Akihiko Okuyama, Kazunari Tanabe, Hiroshi Toma, Kazuharu Uchida, Akira Hasegawa, Norio Yoshimura, Yoriaki KamiryoAbstract:Owing to the severe shortage of cadaveric grafts in Japan, we have performed ABO-incompatible living donor kidney Transplantation since 1989. This study assessed short- and long-term outcomes in 441 patients who received ABO-incompatible living donor kidney transplants between January 1989 and December 2001. We compared our results with historical data from 1055 recipients of living kidney Transplantation. Overall patient survival rates 1, 3, 5, 7, and 9 years after ABO-incompatible Transplantation were 93%, 89%, 87%, 85%, and 84%, respectively. Corresponding overall graft survival rates were 84%, 80%, 71%, 65%, and 59%. After ABO-incompatible Transplantation, graft survival rates were significantly higher in patients 29 years or younger than in those 30 years or older and in patients who received anticoagulation therapy than in those who did not receive such therapy. There were no significant differences between A-incompatible and B-incompatible recipients with respect to clinical outcomes. The graft survival rate at 1 year in the historical controls was slightly but not significantly higher than that in our recipients of ABO-incompatible transplants. We conclude that long-term outcome in recipients of ABO-incompatible living kidneys is excellent. Transplantation of ABO-incompatible kidneys from living donors is a radical, but effective treatment for end-stage renal disease.
Kazunari Tanabe - One of the best experts on this subject based on the ideXlab platform.
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excellent long term outcome of abo incompatible living donor kidney Transplantation in japan
American Journal of Transplantation, 2004Co-Authors: Kota Takahashi, Kazuhide Saito, Shiro Takahara, Akihiko Okuyama, Kazunari Tanabe, Hiroshi Toma, Kazuharu Uchida, Akira Hasegawa, Norio Yoshimura, Yoriaki KamiryoAbstract:Owing to the severe shortage of cadaveric grafts in Japan, we have performed ABO-incompatible living donor kidney Transplantation since 1989. This study assessed short- and long-term outcomes in 441 patients who received ABO-incompatible living donor kidney transplants between January 1989 and December 2001. We compared our results with historical data from 1055 recipients of living kidney Transplantation. Overall patient survival rates 1, 3, 5, 7, and 9 years after ABO-incompatible Transplantation were 93%, 89%, 87%, 85%, and 84%, respectively. Corresponding overall graft survival rates were 84%, 80%, 71%, 65%, and 59%. After ABO-incompatible Transplantation, graft survival rates were significantly higher in patients 29 years or younger than in those 30 years or older and in patients who received anticoagulation therapy than in those who did not receive such therapy. There were no significant differences between A-incompatible and B-incompatible recipients with respect to clinical outcomes. The graft survival rate at 1 year in the historical controls was slightly but not significantly higher than that in our recipients of ABO-incompatible transplants. We conclude that long-term outcome in recipients of ABO-incompatible living kidneys is excellent. Transplantation of ABO-incompatible kidneys from living donors is a radical, but effective treatment for end-stage renal disease.
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time dependent risk factors influencing the long term outcome in living renal allografts donor age is a crucial risk factor for long term graft survival more than 5 years after Transplantation
Transplantation, 2001Co-Authors: Hiroshi Toma, Kazunari Tanabe, T Tokumoto, Tomokazu Shimizu, H ShimmuraAbstract:BACKGROUND: Most investigations have revealed that the improvement in early graft survival has not resulted in a corresponding improvement in long-term graft survival. The risk factors for long-term graft survival should be clarified. METHODS: A single-center experience of 1100 consecutive renal transplant recipients who received kidneys from living donors from 1983 to 1998 was reviewed to clarify the time dependency of risk factors for long-term graft survival. We examined various possible risk factors, including HLA-AB and -DR mismatches, ABO-blood group incompatibility, graft weight, donor age and sex, recipient age and sex, and the presence or absence of acute rejection by using the time-dependent, nonproportional Cox's hazards model. RESULTS: Acute rejection episode, donor age, HLA-AB 4-antigen mismatches, ABO-incompatible Transplantation, smaller kidney weight compared with the patient's body weight (Kw/Bw ratio less than 2.67), and Transplantation from an unrelated living donor were risk factors for long-term graft outcome. Multivariate analysis for time-dependent risk factors showed that donor age of more than 60 years was the most important risk factor for long-term graft failure after 5 years postTransplantation (hazard ratio: 2.57). In contrast, acute rejection, ABO incompatibility, and nonrelated donors were significant risk factors for short-term graft failure within 5 years after kidney Transplantation (hazard ratios: 2.68, 1.57, and 1.69, respectively). CONCLUSIONS: Donor age of more than 60 years was a crucial risk factor affecting long-term graft survival. In contrast, acute rejection, ABO incompatibility, and nonrelated donors were significant risk factors for short-term graft failure.
Robert A Montgomery - One of the best experts on this subject based on the ideXlab platform.
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renal Transplantation across hla and abo antibody barriers integrating paired donation into desensitization protocols
American Journal of Transplantation, 2010Co-Authors: Robert A MontgomeryAbstract:The field of desensitization and incompatible Transplantation has made great gains over the past decade. There are now several options and effective therapies for many patients who face antibody barriers. Kidney paired donation (KPD) and desensitization have traditionally been considered competing strategies and patients have been offered one or the other without regard for the probability of a successful outcome. It is now possible to predict which donor/recipient phenotypes will benefit from each of these modalities. KPD should be favored among patients with immunologic phenotypes that are likely to match without prolonged waiting times. However, as many as 50% of patients with incompatible donors will fail to find a match in a KPD pool and many of these patients could be desensitized to their donor. Positive crossmatch and ABO incompatible Transplantation has been accomplished in selective cases without the need for heavy immunosuppression or B-cell ablative therapy. Patients who are both difficult-to-match due to broad sensitization and hard-to-desensitize because of strong donor reactivity can often be successfully transplanted through a combination of desensitization and KPD. Using these various modalities it is estimated that most patients with incompatible live donors can undergo successful renal Transplantation.
