The impact of allograft nephrectomy on percent panel reactive antibody and clinical outcome

2003 ◽  
Vol 35 (2) ◽  
pp. 862-863 ◽  
Author(s):  
A.K Khakhar ◽  
V.B Shahinian ◽  
A.A House ◽  
N Muirhead ◽  
D.J Hollomby ◽  
...  
Keyword(s):  
Clinical Outcome ◽  
Panel Reactive Antibody ◽  
Allograft Nephrectomy ◽  
The Impact ◽  
Reactive Antibody

scholarly journals Extracapsular versus intracapsular allograft nephrectomy: impact on allosensitization and surgical outcomes

2013 ◽  
Vol 5 (1) ◽  
pp. 49 ◽  
Author(s):  
Naji J. Touma ◽  
Alp Sener ◽  
Yves Caumartin ◽  
Jeff Warren ◽  
Christopher Y. Nguan ◽  
...  
Keyword(s):  
Postoperative Complications ◽  
Blood Loss ◽  
Surgical Outcomes ◽  
Panel Reactive Antibody ◽  
Transplant Patients ◽  
The Mean ◽  
Allograft Nephrectomy ◽  
The Impact ◽  
Reactive Antibody

Introduction: Our objective was to compare the impact of extracapsular(ECAN) versus intracapsular allograft nephrectomy (ICAN)on allosensitization and surgical outcomes.Methods: Between 1990 and 2004, 96 allograft nephrectomieswere performed at our institution. Of these, 29 procedures wereperformed within 1 month of the transplant and were thereforeomitted from analysis. Overall, the results of 44 ECAN and 23ICAN were reviewed.Results: The mean operative times were 110.9 versus 130.4 minfor ICAN versus ECAN (p = 0.02) and the estimated blood losswas 226 mL for ICAN versus 483 mL for ECAN (p = 0.004).Intraoperative and postoperative complications were low usingeither technique and differences were not statistically significant.Overall, the preoperative to postoperative change in the percentageof panel reactive antibody was +2.1% for ICAN versus +1.2% forECAN (NS) at 3 to 12 months postoperatively, respectively (NS).The percentage of patients relisted was 33.3% versus 54.3% (NS),and the percentage of patients re-transplanted once relisted wasalso very similar: 63.2% for ECAN versus 66.7% for ICAN (NS),after a mean follow-up of 4.5 and 8.4 years, respectively.Conclusions: ICAN can be performed with shorter operative timesand less blood loss versus the extracapsular approach. As well, thisoperative approach does not appear to affect allosensitization andthe ability to re-transplant patients.

scholarly journals Early but not late allograft nephrectomy reduces allosensitization after transplant failure

2013 ◽  
Vol 5 (6) ◽  
pp. 142
Author(s):  
Alp Sener ◽  
Anand K. Khakhar ◽  
Christopher Y. Nguan ◽  
Andrew A. House ◽  
Anthony M. Jevnikar ◽  
...  
Keyword(s):  
Graft Failure ◽  
Low Dose ◽  
Early Failure ◽  
Group I ◽  
Transplant Failure ◽  
Group Ii ◽  
Allograft Nephrectomy ◽  
The Impact ◽  
Reactive Antibody

Introduction: Allosensitization is a significant obstacle to retransplantationfor patients with primary renal graft failure.Methods: We assessed the impact of allograft nephrectomy(Group I) and weaning of immunosuppression (Group II) on percentpanel reactive antibody (%PRA) at various time points after graftfailure in 132 patients with a median follow-up of 47 months. Ofthese, 68% had allograft nephrectomy while 32% were placed onthe waiting list and were either taken off immunosuppression, lefton prednisone or on low-dose immunosuppressive therapy.Results: When groups were stratified into early (<6 months) andlate (>6 months) graft failure, patients who had transplant nephrectomyfor early failure demonstrated a decline in %PRA from46% at time of graft failure to 27% at last follow-up (p = 0.02);conversely, %PRA continued to rise in Group II experiencing earlyallograft failure. Both Groups I and II patients with late graft failuremaintained elevated %PRA at last follow-up.Conclusion: Allograft nephrectomy may play a role in limitingallosensitization in patients with early but not late graft failures.RésuméIntroduction : L’allosensibilisation est un obstacle important à laretransplantation chez les patients présentant un échec primairede la greffe rénale.Méthodologie : Nous avons évalué l’impact d’une néphrectomiedu greffon (groupe I) et du sevrage de l’immunosuppression (groupeII) sur le taux d’immunisation (PRA pour panel reactive antibody) àdifférents points dans le temps après l’échec de la greffe chez 132patients; le suivi médian était de 47 mois. Sur les 132 patients, 68% ont subi une néphrectomie du greffon, tandis que 32 % ont étéplacés sur la liste d’attente, et on a soit mis fin à leur traitementd’immunosuppression, soit poursuivi leur traitement par prednisoneou par un agent immunosuppresseur à faible dose.Résultats : Lorsque les groupes ont été stratifiés en fonction del’échec précoce (< 6 mois) et tardif (> 6 mois) de la greffe, lespatients qui ont subi une néphrectomie du greffon en raison d’unéchec précoce ont montré une baisse du PRA, passant de 46 %au moment de l’échec de la greffe à 27 % lors du dernier suivi(p = 0,02); en revanche, le PRA a continué d’augmenter chez lespatients du groupe II qui ont présenté un échec précoce de la greffe.Dans les deux groupes, les patients ayant présenté un échec tardifde la greffe présentaient toujours un PRA élevé lors du dernier suivi.Conclusion : La néphrectomie du greffon peut contribuer à limiterl’allosensibilisation dans les cas d’échec précoce de la greffe, maispas dans les cas d’échec tardif.

scholarly journals LINC-25. BRAF ABERRATIONS IN PEDIATRIC PILOCYTIC ASTROCYTOMAS (PCAs): PREVALENCE AND IMPACT ON CLINICAL OUTCOME

2020 ◽  
Vol 22 (Supplement_3) ◽  
pp. iii383-iii383
Author(s):  
Subramaniam Ramanathan ◽  
Maya Prasad ◽  
Tushar Vora ◽  
Mamta Gurav ◽  
Ayushi Sahay ◽  
...  
Keyword(s):  
Clinical Outcome ◽  
Statistical Significance ◽  
Tumor Resection ◽  
Brafv600e Mutation ◽  
Therapeutic Implications ◽  
Pilocytic Astrocytomas ◽  
Ffpe Tissues ◽  
Braf Fusion ◽  
Poor Outcomes ◽  
The Impact

Abstract BACKGROUND Increasing knowledge on pilocytic astrocytoma (PCA) biology now points towards an aberration in BRAF/MAPK/ERK pathway which has both diagnostic and therapeutic implications. This study was done to note the impact of BRAF aberrations on clinical outcome in childhood PCA. METHODS FFPE tissues of all childhood PCA diagnosed during 2011–2017 were evaluated for BRAFV600E mutation by Sanger sequencing and KIAA1549 fusion transcripts (16–9;15–9;16-11) by reverse transcriptase polymerase chain reaction. Children undergoing gross tumor resection received no adjuvant treatment. Unresectable tumors (only biopsy) and NF-1 associated PCAs, were treated if clinically indicated. Only patients with documented therapy details/followup were included for analysis. STUDY RESULTS Ninety-eight patients (median age-7.7yrs; boy:girl ratio-1.4) were included. Major sites were: Cerebellum-37(38%), 3rd Ventricle-26(27%), Cerebrum-15(15%). While BRAFV600E mutation was noted in 7/89(8%) specimens, BRAF-fusions were found in 34/85(40%). Following surgery/biopsy, 23(24%) and 21(22%) received adjuvant chemotherapy and radiotherapy respectively. The 1-year/3-year/5-year-EFS of the overall cohort was 90.7%/81.3%/67.4% respectively. Cerebellar tumors did better vis-à-vis other sites(5yr-EFS:74.3% v/s 66.4%;p=0.403). The 5yr-EFS of BRAF-fusion positive tumors (34), tumors without any BRAF aberration (40) and BRAFV600E mutant tumors (7) was 84.8%/ 69.6%/ 42.9% (p=0.215). CONCLUSIONS BRAF-fusion and BRAFV600E mutation were associated with good and poor outcomes respectively. Lack of statistical significance could be attributed to use of radiation as planned therapy in patients from earlier years. Data on BRAF aberrations in PCAs aids decision making regarding adjuvant therapy and choosing appropriate salvage-therapy especially in relapsed/refractory PCAs.

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