Renal Transplantation in High Immunological Risk Patients: A Single-Center Experience.
Transplant Proc
; 51(7): 2298-2301, 2019 Sep.
Article
en En
| MEDLINE
| ID: mdl-31405734
ABSTRACT
BACKGROUND:
Renal transplantation (RT) in high-risk patients is increasingly performed due to an inadequate organ pool and increased rate of RT after a failed transplantation. Safety and prognosis of RT in such patients with high risk is an ongoing debate. Herein we aimed to present our single-center experience on RT of high-risk patients.METHODS:
A total of 89 consecutive RT patients were included into this study in a 10-month period. Patients were divided into 3 groups the low-risk group (n = 47) with negative panel reactive antibody (PRA), medium-risk group (n = 18) with positive PRA but mean fluorescence intensity (MFI) < 2000, and high-risk group (n = 24) with positive PRA and MFI >2000 or donor specific antibody (DSA) positivity. Groups were compared in terms of demographic features, serum creatinine levels, acute rejection rates, delayed graft function (DGF), and patient or graft loss.RESULTS:
Age of the recipients were similar between the groups. Desensitization (7% vs 11% vs 42%, respectively, in low-, medium-, and high-risk groups; P = .001), plasmapheresis (6% vs 11% vs 46%, respectively, P < .001), and rituximab treatments (0% vs 0% vs 25%, respectively, P < .001) were significantly more frequently performed in high-risk patients. Serum creatinine levels at 1 month and 6 months after RT were similar between the groups (P = .43 and P = .71, respectively). Rates of acute rejection (6% vs 6% vs 16%, respectively, P = .52) and DGF (9% vs 11% vs 29%, respectively, P = .15) were similar between the groups. Frequencies of loss of patient or graft were also similar (0% vs 6% vs 4%, P = .15).CONCLUSION:
RT may be successfully performed in high-risk patients without an increase in the risk of acute rejection, DGF, or patient/graft loss.
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Desensibilización Inmunológica
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Trasplante de Riñón
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Plasmaféresis
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Rituximab
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Rechazo de Injerto
Tipo de estudio:
Etiology_studies
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Evaluation_studies
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Prognostic_studies
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Risk_factors_studies
Límite:
Adult
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Female
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Humans
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Male
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Middle aged
Idioma:
En
Revista:
Transplant Proc
Año:
2019
Tipo del documento:
Article