Twenty Years of Renal Transplantation in Children

PEDIATRICS ◽  
1986 ◽  
Vol 77 (4) ◽  
pp. 465-470
Author(s):  
Donald Potter ◽  
Nicholas Feduska ◽  
Juliet Melzer ◽  
Marvin Garovoy ◽  
Susan Hopper ◽  
...  
Keyword(s):  
Overall Survival ◽  
Renal Transplantation ◽  
Survival Rate ◽  
Living Donor ◽  
Patient Survival ◽  
Survival Rates ◽  
Overall Survival Rate ◽  
Creatinine Concentration ◽  
The Mean ◽  
Cadaver Donor

Two-hundred three children 1 to 16 years of age received kidney transplants during a 20-year period, 100 from living donors and 103 from cadaver donors. The overall survival rate was 79%. Actuarial patient and kidney survival rates at 15 years were 79% and 52%, respectively, for recipients of living donor kidneys and 57% and 19%, respectively, for recipients of cadaver donor kidneys. One of two children who received transplants in 1964 was alive 20½ years later. Twenty-nine children had kidneys that had functioned more than 10 years; their mean serum creatinine concentration was 1.7 mg/dL and 24 were fully rehabilitated. Eighteen were more than 2 SD below the mean height of normal chidren, however. Comparison of survival rates during successive 5-year intervals showed significant improvement in patient survival during the 20-year period and smaller improvements in kidney survival after 1979. Patient survival after living donor transplants during the last 10 years was 100%, and kidney survival during the last 5 years was 92%. Improvement was attributed to the effect of experience, as well as to changes in immunosuppressive therapy in 1972 and the introduction of donor-specific transfusions in 1978.

scholarly journals Evaluation of effect of epidermal growth factor receptor and vascular endothelial growth factor overexpression in survival of patients with glioblastoma multiforme

2021 ◽  
Vol 20 (1) ◽  
pp. 66-71
Author(s):  
Babak Alijani ◽  
◽  
Hamid Saeidi Saedi ◽  
Hadi Hajizadeh Fallah ◽  
Ehsan Kazemnejad Leili ◽  
...  
Keyword(s):  
Overall Survival ◽  
Survival Rate ◽  
Growth Factor ◽  
Glioblastoma Multiforme ◽  
Survival Rates ◽  
Growth Factor Receptor ◽  
Overall Survival Rate ◽  
Significant Difference ◽  
The Central Nervous System ◽  
The Mean

Background. In the central nervous system, glioblastoma multiforme (GBM) is one of the most important neoplasms in adults. Amplification of EGFR and VEGF genes is common in GBM. However, the role of overexpression of EGFR and VEGF in survival of patients with GBM has been a contentious issue. Therefore, we performed the present study to assess the survival rate of patients with EGFR and VEGF overexpression. Materials and methods. Resected samples of GBM patients were evaluated by immunohistochemistry for overexpression of VEGF and EGFR. The patients were followed up for a year. Results. The mean±sd of age of patients was 56.2±13.1 years. The majority of the patients were male (65.9%). Most of the patients had primary GBM (67%), notwithstanding 33% of the patients with secondary GBM. Moreover, 19.2% and 49.5% of the samples were VEGF-positive and EGFR-positive, respectively. Overall 6, 12-, and 18-month survival rates were shown to be 61.5±5.1%, 17.6±4%, and 4.4±2.1%, respectively. There was a significant difference between the mean±se survival rate in VEGF-negative patients (12±1.9 months) VEGF-positive patients (7.8±0.5 months) (P=0.045). Conclusions. We found an association between VEGF and EGFR over-expression and the survival rate of GBM patients. The VEGF overexpression was significantly associated with the overall survival rate of the GBM patients, but failed to have a prognostic value for their mortality rate. However, EGFR was a predictor of overall survival rate and mortality of GBM patients. Moreover, VEGF overexertion has a stronger association with survival rate in GBM, compared to EGFR overexpression.

Renal transplantation in the first year of life: the treatment of choice for infants with end-stage renal disease.

1992 ◽  
Vol 2 (12) ◽  
pp. S228
Author(s):  
J S Najarian ◽  
P S Almond ◽  
M Mauer ◽  
B Chavers ◽  
T Nevins ◽  
...  
Keyword(s):  
Renal Failure ◽  
Renal Transplantation ◽  
Survival Rate ◽  
Living Donor ◽  
Patient Survival ◽  
First Year ◽  
End Stage Renal Failure ◽  
End Stage ◽  
First Year Of Life ◽  
Patient Survival Rate

The treatment of choice for end-stage renal failure within the first year of life is controversial. Between September 1970 and February 1991, we performed 28 kidney transplants (27 primary, 1 retransplant, 23 living donor, 5 cadaver) in infants less than 1 yr of age (mean, 7 +/- 2 months; range, 6 wk to 12 months). The 1-yr patient survival rate for living donor recipients was 100% versus 20% for cadaver recipients (P = 0.0001). The 1-yr graft survival rate for living donor recipients was 96% versus 20% for cadaver recipients (P = 0.001). The 1-yr patient survival rate for cyclosporin A (CSA) recipients (N = 12) was 100% versus 75% for non-CSA recipients (P = 0.03). The 1-yr graft survival rate for CSA recipients was 92% versus 75% for non-CSA recipients (P = 0.08). There was no difference in the number of rejection episodes or serum creatinine levels in CSA versus non-CSA recipients. Compared with pretransplant values, the mean posttransplant standard deviation scores (SDS) for height (N = 18), weight (N = 22), and head circumference (N = 8) improved: height SDS from -1.9 to -1.5 (not significant); weight SDS from -2.5 to 0.6 (P less than 0.0005); head circumference SDS from -2.0 to -0.7 (P = 0.01). Because no other renal replacement therapy can match these results, we conclude that renal transplantation is the treatment of choice for infants with end-stage renal failure.

scholarly journals Short-term outcomes of extremely preterm infants at discharge: a multicenter study from Guangdong province during 2008–2017

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Fan Wu ◽  
Guosheng Liu ◽  
Zhoushan Feng ◽  
Xiaohua Tan ◽  
Chuanzhong Yang ◽  
...  
Keyword(s):  
Overall Survival ◽  
Birth Weight ◽  
Survival Rate ◽  
Gestational Age ◽  
Guangdong Province ◽  
Overall Survival Rate ◽  
Short Term ◽  
Extremely Preterm ◽  
The Mean ◽  
Care Withdrawal

Abstract Background An increasing number of extremely preterm (EP) infants have survived worldwide. However, few data have been reported from China. This study was designed to investigate the short-term outcomes of EP infants at discharge in Guangdong province. Methods A total of 2051 EP infants discharged from 26 neonatal intensive care units during 2008–2017 were enrolled. The data from 2008 to 2012 were collected retrospectively, and from 2013 to 2017 were collected prospectively. Their hospitalization records were reviewed. Results During 2008–2017, the mean gestational age (GA) was 26.68 ± 1.00 weeks and the mean birth weight (BW) was 935 ± 179 g. The overall survival rate at discharge was 52.5%. There were 321 infants (15.7%) died despite active treatment, and 654 infants (31.9%) died after medical care withdrawal. The survival rates increased with advancing GA and BW (p < 0.001). The annual survival rate improved from 36.2% in 2008 to 59.3% in 2017 (p < 0.001). EP infants discharged from hospitals in Guangzhou and Shenzhen cities had a higher survival rate than in others (p < 0.001). The survival rate of EP infants discharged from general hospitals was lower than in specialist hospitals (p < 0.001). The major complications were neonatal respiratory distress syndrome, 88.0% (1804 of 2051), bronchopulmonary dysplasia, 32.3% (374 of 1158), retinopathy of prematurity (any grade), 45.1% (504 of 1117), necrotizing enterocolitis (any stage), 10.1% (160 of 1588), intraventricular hemorrhages (any grade), 37.4% (535 of 1431), and blood culture-positive nosocomial sepsis, 15.7% (250 of 1588). The multivariate logistic regression analysis indicated that improved survival of EP infants was associated with discharged from specialist hospitals, hospitals located in high-level economic development region, increasing gestational age, increasing birth weight, antenatal steroids use and a history of premature rupture of membranes. However, twins or multiple births, Apgar ≤7 at 5 min, cervical incompetence, and decision to withdraw care were associated with decreased survival. Conclusions Our study revealed the short-term outcomes of EP infants at discharge in China. The overall survival rate was lower than the developed countries, and medical care withdrawal was a serious problem. Nonetheless, improvements in care and outcomes have been made annually.

scholarly journals Clinical factors affecting prognosis of limb osteosarcoma in China: a multicenter retrospective analysis

2020 ◽  
Vol 48 (8) ◽  
pp. 030006052093085
Author(s):  
Jia Han ◽  
Yiyang Yu ◽  
Sujia Wu ◽  
Zhen Wang ◽  
Weibin Zhang ◽  
...  
Keyword(s):  
Overall Survival ◽  
Survival Rate ◽  
Cox Regression ◽  
Survival Rates ◽  
Treatment Method ◽  
Overall Survival Rate ◽  
Clinical Factors ◽  
Standard Chemotherapy ◽  
Factors Affecting ◽  
Cox Regression Analysis

Objective This study was performed to explore the relationship between various clinical factors and the prognosis of limb osteosarcoma. Methods We retrospectively analyzed the clinical data of 336 patients with limb osteosarcoma treated from June 2000 to August 2016 at 7 Chinese cancer centers. Data on the patients’ clinical condition, treatment method, complications, recurrences, metastasis, and prognosis were collected and analyzed. Kaplan–Meier analysis and Cox regression models were used to analyze the data. Results The patients comprised 204 males and 132 females ranging in age from 6 to 74 years (average, 21.1 years). The overall 3- and 5-year survival rates were 65.0% and 55.0%, respectively. The 5-year overall survival rate was 64.0% with standard chemotherapy and 45.6% with non-standard chemotherapy. Cox regression analysis demonstrated that standard chemotherapy, surgery, recurrence, and metastasis were independent factors associated with the prognosis of limb osteosarcoma. Conclusion The survival of patients with limb osteosarcoma can be significantly improved by combining standard chemotherapy and surgery. The overall survival rate can also be improved by adding methotrexate to doxorubicin–cisplatin–ifosfamide triple chemotherapy.

scholarly journals Crosstalk between Activated and Inactivated c-Src in Hepatocellular Carcinoma

2011 ◽  
Vol 30 (6) ◽  
pp. 325-333 ◽  
Author(s):  
Mei-Lin Chen ◽  
Chee-Yin Chai ◽  
Kun-Tu Yeh ◽  
Shen-Nien Wang ◽  
Chia-Jung Tsai ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Overall Survival ◽  
Survival Rate ◽  
Cox Regression ◽  
Patient Survival ◽  
Survival Curve ◽  
Clinicopathological Characteristics ◽  
Active State ◽  
Overall Survival Rate ◽  
Independent Prognostic Marker

C-Src activity is regulated by tyrosine phosphorylation at two distinct sites, Tyr416 and Tyr527, with opposite effects. However, the clinical roles of these sites in human cancers are not well defined. This study aims to determine whether the alterations and crosstalk of these two sites may contribute to hepatocellular carcinoma (HCC). Specimens from 85 patients who had undergone curative hepatectomy were collected for this study. The patterns of p-Tyr416-Src and p-Tyr527-Src, as well as the non-phosphorylated status for each site, were determined using immunohistochemistry and statistically correlated with clinicopathological characteristics and overall survival rate. The active state of c-Src, p-Tyr416-c-Src, was positively correlated with tumour grade (P= 0.062) but inversely correlated with vascular invasion (P= 0.071). Its non-phosphorylated status, non-p-Tyr416-c-Src, was positively correlated with tumour stage and grade (P= 0.041 and 0.020). The inactive state of c-Src, p-Tyr527-c-Src, was decreased in male patients but increased HCV-infected patients (P= 0.044 and 0.033). The Kaplan-Meier survival curve further showed that increased p-Tyr416-c-Src and decreased non-p-Tyr527-c-Src expression were associated with a poor patient survival rate (P= 0.004 and 0.025). Interestingly, the expression of non-p-Tyr416-c-Src was positively correlated with that of p-Tyr527-c-Src in the HCC lesions (P= 0.040). In addition, the patients with concomitantly low p-Tyr416-c-Src and non-p-Tyr527-c-Src expression had a prolonged overall survival rate (P= 0.030). A multivariable COX regression model showed that p-Tyr416-c-Src expression was an effective predictor for patient survival in HCC [OR = 3.78, 95%CI = 1.46–9.76;P= 0.006]. Our results suggest that the active state of c-Src, p-Tyr416-c-Src, may serve as an independent prognostic marker of patient survival in HCC. Relative levels of other phosphorylated or non-phosphorylated c-Src kinases may also present different statuses during HCC development and require further investigation.

scholarly journals Comparison of prognosis between emergency and scheduled hemodialysis

2019 ◽  
Vol 47 (3) ◽  
pp. 1221-1231 ◽  
Author(s):  
Zhixiang Bian ◽  
Huiyi Gu ◽  
Peihua Chen ◽  
Shijian Zhu
Keyword(s):  
Overall Survival ◽  
Survival Rate ◽  
Mortality Rate ◽  
Serum Creatinine ◽  
Survival Rates ◽  
Overall Survival Rate ◽  
Short Term ◽  
Term Survival ◽  
Renal Replacement Therapies

Background The survival rate of patients undergoing hemodialysis and other renal replacement therapies has been extensively studied, but comparative studies of emergency and scheduled hemodialysis are limited. Methods This study included 312 patients who underwent emergency hemodialysis and 274 who received scheduled hemodialysis. We investigated the prognostic differences between these two groups of patients, including the short-term and long-term survival rates. Results The overall survival rate was significantly better among the patients in the scheduled hemodialysis group than emergency hemodialysis group. The mortality rate within 3 months of emergency hemodialysis was 4.8%, while that within 3 months of scheduled hemodialysis was 1.1%. Conclusions Significant differences were present between emergency and scheduled hemodialysis, especially the levels of serum creatinine and hemoglobin.

Bladder preservation by combined modality therapy for invasive bladder cancer.

1997 ◽  
Vol 15 (3) ◽  
pp. 1022-1029 ◽  
Author(s):  
L A Kachnic ◽  
D S Kaufman ◽  
N M Heney ◽  
A F Althausen ◽  
P P Griffin ◽  
...  
Keyword(s):  
Overall Survival ◽  
Bladder Cancer ◽  
Survival Rate ◽  
Combined Modality Therapy ◽  
Clinical Stage ◽  
Survival Rates ◽  
Overall Survival Rate ◽  
Bladder Preservation ◽  
Combined Modality ◽  
Long Term Survivors

PURPOSE To update the efficacy of a selective multimodality bladder-preserving approach by transurethral resection (TURBT), systemic chemotherapy, and radiation therapy. PATIENTS AND METHODS From 1986 through 1993, 106 patients with muscle-invading clinical stage T2 to T4a,Nx,M0 bladder cancer were treated with induction by maximal TURBT and two cycles of chemotherapy (methotrexate, cisplatin, vinblastine [MCV]) followed by 39.6-Gy pelvic irradiation with concomitant cisplatin. Patients with a negative postinduction therapy tumor site biopsy and cytology (a T0 response, 70 patients) plus those with less than a T0 response but medically unfit for cystectomy (six patients), received consolidative chemoradiation to a total of 64.8 Gy. Surgical candidates with less than a T0 response (13 patients) and patients who could not tolerate the chemoradiation (six patients) went to immediate cystectomy. The median follow-up duration is 4.4 years. RESULTS The 5-year actuarial overall survival and disease-specific survival rates of all patients are 52% and 60%, respectively. For clinical stage T2 patients, the actuarial overall survival rate is 63%, and for T3-4, 45%. Thirty-six patients (34%) underwent cystectomy, all with evidence of tumor activity, including 17 with an invasive recurrence. The 5-year overall survival rate with an intact functioning bladder is 43%. Among 76 patients who completed bladder-preserving therapy, the 5-year rate of freedom from an invasive bladder relapse is 79%. No patient required cystectomy for treatment-related bladder morbidity. CONCLUSION Combined modality therapy with TURBT, chemotherapy, radiation, and selection for organ-conservation by response has a 52% overall survival rate. This result is similar to cystectomy-based studies for patients of similar age and clinical stages. The majority of the long-term survivors retain fully functional bladders.

The effect of chemotherapy on overall survival of stage II colon cancer.

2011 ◽  
Vol 29 (4_suppl) ◽  
pp. 625-625
Author(s):  
M. Omaira ◽  
M. Mozayen ◽  
K. Katato
Keyword(s):  
Colon Cancer ◽  
Overall Survival ◽  
Survival Rate ◽  
Survival Rates ◽  
Stage Ii ◽  
Disease Stage ◽  
Overall Survival Rate ◽  
Significant Difference ◽  
Stage Ii Colon Cancer

625 Background: Surgical resection of local colon cancer is the only curative treatment, at the same time adjuvant chemotherapy is clearly shown to be beneficial as the standard of care for node positive disease (stage III) colon cancer. However the role of chemotherapy for stage II colon cancer treatment is still conflicting. We aim to compare the overall survival rate of stage II colon cancer patient's with and without chemotherapy. Methods: A retrospective observational study was conducted from 1990-2006. Patients with stage II colon cancer were included. Patient's characteristics including age, gender, common site of involvement, histology patterns, overall survival rate and treatment with chemotherapy were recorded. Results: A total of 138 consecutive patients were identified from 1990-2006. The median age was 68 (21-91) year, males (44%), African Americans (47.6%). The most common sites of the primary tumor were sigmoid and cecum (22.4%) each. Adenocarcinoma being the most common pathology. Majority of the patients (86.2%) were found to have T 3 tumors. Of the patients that received chemotherapy (29/44) 66% had an overall survival rate of three years or more, whereas (53/94) 57% of the patients who did not receive chemotherapy had a survival rate of three years or more. The difference of survival rates between the two groups of patients was not statistically significant. Conclusions: The role of chemotherapy in stage II colon ancer is still controversial. There was no significant difference in overall survival between the two groups who did and did not receive chemotherapy; thus more studies are warranted to explore the factors that predict the survival of stage II colon cancer. No significant financial relationships to disclose.

Impact of obesity upon the survival of cholangiocarcinoma patients.

2019 ◽  
Vol 37 (4_suppl) ◽  
pp. 288-288
Author(s):  
Phani Keerthi Surapaneni ◽  
Zhuo Li ◽  
Lalitha Padmanabha Vemireddy ◽  
Pashtoon Murtaza Kasi ◽  
Jason Scott Starr ◽  
...  
Keyword(s):  
Overall Survival ◽  
Survival Rate ◽  
Survival Rates ◽  
Tumor Location ◽  
Normal Weight ◽  
Categorical Variables ◽  
Overall Survival Rate ◽  
Exact Test ◽  
Significant Difference ◽  
The Impact

288 Background: Obesity is a risk factor for developing cholangiocarcinoma (CCA). However, the effect of obesity on survival of CCA is unclear. The primary aim of this study was to analyze the impact of obesity upon overall survival of CCA patients. Secondary aims were to analyze impact of obesity upon other disease characteristics such as tumor site, stage, age, sex, BMI and Ca 19-9. Methods: A total of 411 unique pts diagnosed with CCA at Mayo Clinic Florida between 2000 and 2018 were retrieved from our collective SDMS database. Variables evaluated included:demographics, Body Mass Index (BMI), AJCC stage, tumor location and Ca 19-9.A total of 185 pts had all data available pertaining to these variables. We further restricted the analysis to pts with intrahepatic CCA classified BMI as per CDC criteria normal (18.5-25kg/m2), overweight (25-29.9kg/m2) and obese (≥30 kg/m2), thus leaving a total of 152 pts. Continuous and categorical variables were compared across BMI groups using Chi-squared or Fisher’s exact test. Overall survival rates after diagnosis at 1, 2 and 3 years were estimated using Kaplan-Meier method. Results: Among 152 pts included in the study, 28% were normal weight, 40% were overweight and 32% were obese. The overall survival rate at 1, 2 and 3 years for normal weight pts with all stages combined was 54.1%, 35%, and 30.7%, respectively. The overall survival rate at 1, 2 and 3 years for overweight pts with all stages combined was 59.7 %, 32.6%, and 25.4%, respectively. The overall survival rate at 1, 2 and 3 years for obese pts with all stages combined was 63.9%, 37.6%, and 26.7%, respectively(p = 0.8766). Multivariate analysis demonstrated is no significant difference in overall survival for obese pts compared to normal or overweight pts.(Table to be shown) However it showed, gender and Ca19-9 were statistically significant predictors of overall survival, with males and pts with Ca19-9≥100 doing worse (HR1.65 (CI = 1.05, 2.61, p = 0.031) and HR 2.31 (CI = 1.49, 3.59, p = < 0.01), respectively). Conclusions: BMI did not make a significant impact on the overall survival, though there may be a trend toward worse OS for ptswith higher BMI. A larger, stage focused evaluation is warranted for further exploration of this trend.

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