scholarly journals Analysis of recipient and graft survival after primary and second kidney transplantation

Author(s):  
A. V. Pinchuk ◽  
N. V. Shmarina ◽  
I. V. Dmitriev ◽  
V. E. Vinogradov ◽  
A. I. Kazantsev

Objective: to evaluate the 1- and 5-year graft and recipient survival after primary and second kidney transplantation, to compare the outcomes depending on the age of recipients.Material and methods. The treatment outcomes for 364 patients who underwent kidney transplantation at Sklifosovsky Research Institute of Emergency Care, Moscow over the period from 2007 to 2019. Of these, 213 patients underwent kidney transplantation for the first time, while 151 patients were having a second transplantation. We analyzed the effect of previous transplants, as well as the age of the recipients on long-term survival rates.Results. No significant difference in 1- and 5-year survival of kidney recipients after primary and second transplantations was found. In contrast, the long-term graft survival significantly depended on this criterion and turned out to be significantly higher after primary transplantations. The 1- and 5-year survival of older recipients was lower than the survival of younger recipients after primary and second kidney transplantation. The 1-year graft survival after primary kidney transplantation was higher in young recipients than in older recipients of the same group, however, but there were no significant differences in the 5-year graft survival. After second transplantations, there were no significant differences in the 1- and 5-year graft survival depending on the age of recipients.Conclusion. A history of previous transplantation is an important factor in kidney transplantation outcome, which must be taken into account in clinical practice.

2017 ◽  
Vol 33 (03) ◽  
pp. 339-346
Author(s):  
Nebil Yesiloglu ◽  
Özlem Kaya ◽  
Feriha Ercan ◽  
Gaye Filinte ◽  
Hakan Sirinoglu

AbstractAutologous fat transfer is a commonly used procedure in plastic surgery practice. The long-term survival rate of fat grafts is the most important issue for satisfactory results. The presented study includes the effects of different tumescent solutions on long-term fat graft survival. A total of 24 rats were divided into four groups: sham, lidocaine, adrenaline, and lidocaine + adrenaline groups. In all groups except the sham group, right inguinal fat pad was harvested 10 minutes after injecting 5 cc of the appropriate tumescent solution. The fat pad was trimmed and reimplanted to the interscapular area. After 3 months, fat pad was reharvested and sent for histopathologic evaluation. The harvested fat grafts were weighted in both surgical sessions. A significant difference was observed in comparison of fat grafts weights between the initial operation and the postoperative third month (p = 0.002). By intergroup comparisons, a significant difference was observed between sham and adrenaline groups (p = 0.002) and between sham and lidocaine + adrenaline groups (p = 0.007). No statistical difference was observed by the comparison of TUNNEL results (p = 0.663). The histopathologic evaluation of the specimens revealed similar results between groups. The injection of tumescent solutions containing only lidocaine before fat harvesting yields similar long-term fat graft survival rates in comparison to the conduction of surgical procedure without injecting any tumescent fluid. However, the injection of solutions containing adrenaline with or without lidocaine may decrease the long-term survival rates of fat autografts.


Author(s):  
Hsiao ◽  
Chen ◽  
Meir ◽  
Tan ◽  
Hsiao ◽  
...  

To determine the comparative efficacy and safety of penetrating keratoplasty (PK) and Descemet stripping automated endothelial keratoplasty (DSAEK) in the Asian population receiving imported donor corneas, our single-center retrospective study provides analysis supporting the transition from PK to DSAEK in the Asian population using imported American donor corneas. We analyzed 259 patients with 241 and 57 cases of PK and DSAEK respectively during 2008 to 2017 using imported corneas at Chang Gung Memorial Hospital, Linkou, Taiwan. In terms of long-term graft survival analysis, there was no difference between PK and DSAEK (log-rank p = 0.386, HR = 0.920, 95% CI: [0.641–1.380]). However, Cox proportional regression analysis revealed that corneal survival rate of DSAEK group in the first 100 days after transplantation was inferior than that of PK group (log-rank p < 0.001, HR = 2.733, 95% CI: [1.501–4.977])]. Despite the inferior survival rate, there were significantly less neovascularization and Descemet membrane folds in the DSAEK group. Importantly, the non-complication rate of DSAEK was much higher than that of PK with significant difference (PK, 25.7% vs DSAEK 42.0%, p = 0.022). Collectively, DSAEK is suggested as an alternative surgical modality in Asian patients using imported American donor corneas because of less complication, and no difference in long-term corneal graft survival rates between PK and DSAEK.


2021 ◽  
Vol 12 ◽  
Author(s):  
Jiawei Peng ◽  
Helong Dai ◽  
Hedong Zhang ◽  
Shaojie Yu ◽  
Xubiao Xie ◽  
...  

BackgroundKidney transplantation from donors who weigh ≤5 kg is performed at only a few transplant centers owing to the high complication and low graft survival rates associated with this approach.MethodsWe retrospectively compared the results of kidney transplantation at our center between January 2015 and December 2019 based on the following pediatric donor criteria: donor body weight ≤5 kg (n=32), 5 kg&lt; donor weight ≤20 kg (n=143), and donor weight &gt;20 kg (n=110). We also perform subgroup analysis of kidney transplantation outcomes from ≤5 kg donors, using conventional (dual separate and classic en-bloc KTx)/novel (en-bloc KTx with outflow tract) surgical methods and allocating to adult/pediatric recipients.ResultsThe death-censored graft survival rates from extremely low body weight ≤5kg at 1 month, and 1, 3, and 5 years were 90.6%, 80.9%, 77.5%, and 73.9%, respectively, which were significantly lower than that from larger body weight pediatric donors. However, the 3-, and 5-year post-transplantation eGFRs were not significantly different between the pediatric and adult recipient group. The thrombosis (18.8%) and urinary leakage (18.8%) rates were significantly higher in the donor weight ≤5 kg group. Compared with 5 kg&lt; donor weight ≤20 kg group, donor weight ≤5kg group was at elevated risk of graft loss due to thrombosis (OR: 13.4) and acute rejection (OR: 6.7). No significant difference on the outcomes of extremely low body weight donor kidney transplantation was observed between adults and pediatric recipients. Urinary leakage rate is significantly lower in the novel operation (8.7%) than in the conventional operation group (44.4%).ConclusionsAlthough the outcomes of donor body weight ≤5kg kidney transplantation is inferior to that from donors with large body weight, it can be improved through technical improvement. Donors with body weight ≤5 kg can be considered as an useful source to expand the donor pool.


2018 ◽  
Vol 27 (04) ◽  
pp. 202-207 ◽  
Author(s):  
Anastasiya Rzhannikova ◽  
Sergey Chernyshev ◽  
Lev Kardapoltsev ◽  
Eduard Idov ◽  
Sergey Berdnikov ◽  
...  

This study looks at 10-year follow-up outcomes of alcohol septal ablation in patients with obstructive hypertrophic cardiomyopathy.Between 2000 and 2008, 40 patients with obstructive hypertrophic cardiomyopathy (27 males, 13 females) underwent alcohol septal ablation. The median follow-up period was 123 (2–179) months. The mean age ran to 43.8 + 13.9 years. The initial dose of ethanol (3 mL) was chosen for ablation in all cases.The hospital mortality was 0%. Permanent pacemakers were implanted in 3 of 40 (7.5%) cases in the hospital period. The median clinical follow-up was 123 (2–179) months. Survival rates at 1, 5, 10, and 15 years after the procedure were as follows: 97.5% (95% confidence interval [CI], 95.1–99.9%), 92.5% (95% CI, 94.8–90.2%), 85.0% (95% CI, 82.9–87.1%), and 81.3% (95% CI, 79.3–83.3%), respectively. Seven patients died during follow-up. Sudden death was observed in two cases. Permanent pacemakers were implanted in 2 of 40 (5%) cases in the follow-up. The log-rank test revealed no statistically significant difference between the 15-year survival rate in our cohort and age- and sex-matched general Russian population (p = 0.11113).Alcohol septal ablation provides long-term survival rates that look comparable with age- and sex-matched general population in the 15-year follow-up period.


2006 ◽  
Vol 21 (4) ◽  
pp. 195-198 ◽  
Author(s):  
D Bergqvist ◽  
G Agnelli ◽  
A T Cohen ◽  
P E Nilsson ◽  
A Le Moigne-Amrani ◽  
...  

Objective: ENOXACAN II was a randomized, double-blind trial that showed prolonged (four-week) thromboprophylaxis with enoxaparin to be more effective than and as safe as standard (one-week) thromboprophylaxis in patients undergoing surgery with a curative intent for abdominopelvic cancer. This follow-up study compared long-term, all-cause mortality in both groups. Methods: Survival rates were calculated on the randomized, treated population ( n = 501). The primary efficacy endpoint was survival at one year. An exploratory analysis including survival data up to 44 months was performed. Because some patients were deemed to have undergone palliative as opposed to curative surgery, and there was a significant difference between the treatment groups in the percentage of patients undergoing palliative surgery, the survival analyses were adjusted for the type of surgery performed. Results: When adjusted for type of surgery, there was a trend towards reduced mortality among patients undergoing palliative surgery in the prolonged prophylaxis group (hazard ratio [HR] = 0.598, P = 0.3565) that became more pronounced beyond the pre-specified one year follow-up period (HR = 0.469, P = 0.078). This trend may reflect a beneficial effect of prolonged prophylaxis on survival in the palliative surgery group (one-year survival 65.4 versus 50% for standard prophylaxis). In patients undergoing curative surgery, one-year survival rates were equal in the standard and prolonged prophylaxis groups (93.8 and 93.2%, respectively). Conclusion: Prolonged thromboprophylaxis with enoxaparin may affect long-term survival in palliative surgery for cancer, but further investigation is warranted.


Author(s):  
Samaneh Mozaffarian ◽  
Korosh Etemad ◽  
Mohammad Aghaali ◽  
Soheila Khodakarim ◽  
Sahar Sotoodeh Ghorbani ◽  
...  

Background: Coronary artery disease is the most common cause of death worldwide as well as in Iran. The present study was designed to predict short and long-term survival rates after the first episode of myocardial infarction (MI). Methods: The current research is a retrospective cohort study. The data were collected from the Myocardial Infarction Registry of Iran in a 12-month period leading to March 20, 2014. The variables analyzed included smoking status, past medical history of chronic heart disease, hypertension, diabetes, hyperlipidemia, signs and symptoms during an attack, post-MI complications during hospitalization, the occurrence of arrhythmias, the location of MI, and the place of residence. Survival rates and predictive factors were estimated by the Kaplan–Meier method, the log-rank test, and the Cox model. Results: Totally, 21 181 patients with the first MI were studied. There were 15 328 men (72.4%), and the mean age of the study population was 62.10±13.42 years. During a 1-year period following MI, 2479 patients (11.7%) died. Overall, the survival rates at 28 days, 6 months, and 1 year were estimated to be 0.95 (95% CI: 0.95 to 0.96), 0.90 (95% CI: 0.90 to 0.91), and 0.88 (95% CI: 0.88 to 0.89). After the confounding factors were controlled, history of chronic heart disease (p<0.001), hypertension (p<0.001), and diabetes (p<0.001) had a significant relationship with an increased risk of death and history of hyperlipidemia (p<0.001) and inferior wall MI (p<0.001) had a significant relationship with a decreased risk of death. Conclusion: The results of this study provide evidence for health policy-makers and physicians on the link between MI and its predictive factors.


1998 ◽  
Vol 9 (4) ◽  
pp. 684-691
Author(s):  
R Sesso ◽  
M A Josephson ◽  
M S Anção ◽  
S A Draibe ◽  
D Sigulem

Due to the shortage of cadaveric organs, kidneys from living unrelated donors (LUD) are increasingly being used for transplantation. The long-term outcome for LUD recipients is not completely known. This study was undertaken to evaluate the long-term graft survival in LUD recipients and compare it with that of cadaver donor allograft recipients. Three hundred and sixty-four LUD and 3881 cadaveric kidney recipients were evaluated using data obtained through the Brazilian Renal Transplant Registry. Transplants performed between January 1, 1987, and June 30, 1996, were eligible for analysis. Graft and patient survival were estimated by the Kaplan-Meier method. Sixty percent of the LUD were from spouses. The median duration of follow-up was 23.8 mo (0 to 117.2 mo). Patient survival rates were not significantly different for LUD and cadaveric kidney recipients (69% [95% confidence interval (CI), 61.9 to 76.1%] versus 73.2% [71 to 75.4%] at 5 yr; 69% [61.9 to 76.1%] versus 60.6% [55.1 to 66.1%] at 9.6 yr). Graft survival rates for recipients of LUD allografts were similar to those for cadaveric kidneys at 5 yr (50.1% [43.2 to 57%] versus 50.4% [48.1 to 52.8%]) and higher, although not significantly, at 9.6 yr (45.7% [37.7 to 53.7%] versus 32.7% [26.4 to 39%], respectively, P = 0.14). In a multivariate analysis using the Cox proportional hazards regression model, after adjusting for recipient age, race, history of previous transplantation, and year of transplantation, the risk of graft failure was 16% (95% CI, -3% to 31%) lower for LUD than cadaveric recipients. We conclude that LUD are an excellent alternative to cadaveric kidney donors. The long-term patient and graft survival rates for recipients of LUD allografts are at least as good as those for recipients of cadaveric kidneys.


2015 ◽  
Vol 41 (2) ◽  
pp. 173-177 ◽  
Author(s):  
José Balaguer ◽  
Javier Ata-Ali ◽  
David Peñarrocha-Oltra ◽  
Berta García ◽  
María Peñarrocha-Diago

The study aims were to evaluate survival rates of dental implants in patients wearing maxillary and mandibular overdentures in relation to age, sex, smoking, implant splinting or non-splinting, the maxilla rehabilitated, and number of implants per dental arch. This was a prospective study of patients who were completely edentulous in either mandible or maxilla or both, rehabilitated with implant-retained overdentures, with a follow-up of at least 3 years. 95 patients with 107 overdentures were supported by 360 implants were included in the study. Rehabilitations were monitored over an average of 95 ± 20.3 months (range 36–159). Implant survival in the maxilla was 91.9% and in the mandible 98.6%, representing a statistically significant difference (P &lt; .05). Age, sex and implant splinting did not influence survival rates significantly. Smokers presented a lower survival rate. Implant numbers in the maxilla had a significant influence on survival, 100% for 6 but 85.7% for 4. Three mandibular implants achieved higher survival rates (100%) but with 2 (96.6%) or 4 (99%) survival was lower, although without significant difference. Long-term results suggest that 3-implant mandibular overdentures have an equivalent survival rate to 4-implant overdentures. In the maxilla, results showed that 6 implants may be the best treatment strategy. For smokers with fewer implants retaining the overdentures, there were higher numbers of implant failures.


Medicina ◽  
2007 ◽  
Vol 43 (12) ◽  
pp. 953 ◽  
Author(s):  
Jaanus Kahu ◽  
Aleksander Lõhmus ◽  
Madis Ilmoja ◽  
Ülle Kirsimägi ◽  
Gennadi Timberg ◽  
...  

Objective. The aim of this study was to compare the graft survival after kidney transplantation in patients treated with azathioprine (AZA) or mycophenolate mofetil (MMF) and analyze the significance of different risk factors for graft survival. Material and methods. A total of 137 patients, transplanted between January 1996 and June 2001, were retrospectively divided into two groups: patients who received AZA together with cyclosporine A and methylprednisolone (AZA group, n=72) and patients who received MMF either immediately or were switched from AZA to MMF during 3 months (MMF group, n=65). Results. According to Kaplan-Meier analysis, a 1-year graft survival was 79% in the AZA group and 85% in the MMF group; a 6-year graft survival was 51% and 67%, respectively (P=0.046). Multivariate Cox survival model demonstrated that MMF therapy reduced the risk of graft loss by 34% (P=0.028), while delayed graft function increased the risk of graft loss (risk ratio 2.26, P=0.009). A statistically significant difference in total cholesterol level (6.7 vs. 5.7 mmol/L, respectively; P=0.002), mean systolic blood pressure (145 vs. 134 mmHg, P=0.009), and cyclosporine A daily dose (238 vs. 203 mg, P=0.015) between the AZA and MMF groups at 1 year was revealed. Conclusion. MMF rescue therapy improves the long-term graft survival compared to AZA despite high early rejection rate and avoids the negative impact of acute rejections on graft survival.


2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1165-1166
Author(s):  
S. B. Kocaer ◽  
T. Yüce İnel ◽  
Y. Erez ◽  
A. Köken Avşar ◽  
S. Uslu ◽  
...  

Background:Currently, biologic treatments are used effectively in patients with psoriatic arthritis (PsA).Objectives:The aim of this study was to evaluate and compare long-term drug survival of the first biologic treatments including adalimumab, certolizumab, etanercept, golimumab, infliximab, secukinumab and ustekinumab in patients with PsA.Methods:PsA patients, electronically registered at each visit in the TURKBIO database between 2011 and 2019 were included in the study. PASW 18.0 for Windows was used for statistical analysis. Drug survival rates were calculated by Kaplan Meier method.Results:355 patients (227 women; axial PsA = 48, peripheral PsA = 307) were included in the study (Table 1). Adalimumab was the most commonly used first biologic treatment (n=125; 37.6%). The rate of drug survival was found to be 0.75 at month 60 in patients receiving the first biologic treatment (Figure 1). There was no significant difference in drug survival rate between tumor necrosis factor alpha inhibitor (TNFi) and non-TNFi biologic drugs (p=0.56). No difference was also found in drug survival rates between each biologic treatment.Table 1.Initial demographic and clinical datas of patients with PsAPsA Patients (n=355)Females, n (%)227 (63,9)Age of diagnosis, years*34,6 (27-42)CRP baseline*6 mg/ L (3-15)ESR baseline*24 mm/h (10-38)Smoking, n (%)Current99 (28,5)Never192 (55,3)Previous56 (16,2)HLA B27 positivity,n (%)41 (26,4)First biologic agent, n (%)-TNFi332 (95,4)AdalimumabEtanercept125 (37,6)80 (24,1)Golimumab52 (15,6)Certolizumab44 (13,3)Infliximab31 (9,4)- Other biologic agents16 (4,6)Secukinumab13 (81,3)Ustekinumab3 (18,7)*median (min-max)Conclusion:The results of this study establish that more than half of patients with PsA can remain in their initial biologic treatment over a long term. It has been observed that the choice of biologic treatment did not effect the drug survival in PsA.Disclosure of Interests:None declared


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