Delayed graft function in kidney transplantation

Perico, Norberto; Cattaneo, Dario; Sayegh, Mohamed H.; Remuzzi, Giuseppe

doi:10.1016/s0140-6736(04)17406-0

Cited by 836 publications

(775 citation statements)

References 131 publications

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“…Prolonged tissue ischemia is known to facilitate and amplify the exposure of class I and II MHC antigens of the transplanted organ to the recipient's immune system, favoring immune recognition and increasing the chances of triggering the rejection process. 10 The use of additional doses of immunosuppression for treating those rejections also increases the chances of infectious episodes, and this may justify the association between that variable and the risk for developing infectious episodes. In accordance with that supposition, the use of methylprednisolone has also been significantly associated with a higher risk for developing infectious episodes (OR 1.29, CI 1 -1.68).…”

Section: Discussionmentioning

confidence: 99%

Incidência e fatores de risco para complicações infecciosas no primeiro ano após o transplante renal

Sousa¹,

Galante²,

Barbosa

et al. 2010

J. Bras. Nefrol.

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Introduction: Infectious complications significantly increase morbidity and mortality after renal transplantation. The immunosuppression used is the main risk factor and relates directly to the incidence and severity of infectious events. Methods: This is a retrospective cohort study, which assessed the incidence of infections and their risk factors among 1,676 kidney transplant recipients during the first year of follow-up. Results: Infectious events were observed in 821 (49%) patients. The mean number of infectious episodes among patients with at least one episode was 2.3 (1 -12). The most prevalent infectious complications were as follows: urinary tract infection (31.3%); cytomegalovirus infection (12%); surgical wound infection (10.3%); herpes virus infection (9.1%); pulmonary infection (5.2%); and bloodstream infection (4.3%). Cold ischemia time and the use of deceased donor grafts were important risk factors for infectious episodes. Conclusions: Infections are highly prevalent in the first year following transplantation. The main infectious complication was urinary tract infection.

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Section: Discussionmentioning

confidence: 99%

Incidência e fatores de risco para complicações infecciosas no primeiro ano após o transplante renal

Sousa¹,

Galante²,

Barbosa

et al. 2010

J. Bras. Nefrol.

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“…Not surprisingly, the selection of higher risk donors for higher risk recipients has led to inferior outcomes when compared to the standard criteria donor-recipient cohort. Although the use of ECD kidneys has increased, concerns exist about DGF, the corresponding diminution in function with these kidneys (4,5) and its association with decreased long-term allograft survival (3,(18)(19)(20)(21)(22)(23).…”

Section: Discussionmentioning

confidence: 99%

Pulsatile Perfusion Reduces the Incidence of Delayed Graft Function in Expanded Criteria Donor Kidney Transplantation

Matsuoka

Shah

Aswad

et al. 2006

American Journal of Transplantation

124

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The use of expanded criteria donors (ECD) has been proposed to help combat the discrepancy between organ availability and need. ECD kidneys are associated with delayed graft function (DGF) and worse long-term survival. The aim of this study is to evaluate the impact of pulsatile perfusion (PP) on DGF and graft survival in transplanted ECD kidneys. From January 2000 to December 2003, 4618 ECD kidney-alone transplants were reported to the United Network for Organ Sharing. PP was performed on 912 renal allografts. The prognostic factors of DGF were analyzed using multivariate logistic regression analysis. Risk factors for reduced allograft viability were greater in donors and recipients of PP kidneys. Three-year graft survival of ECD kidneys preserved with PP was similar to cold storage (CS) kidneys. The incidence of DGF in PP kidneys was significantly lower than CS kidneys (26% vs. 36%, p < 0.001). Despite having a greater number of risk factors for reduced graft viability, the ECD-PP kidneys had similar graft survival compared to ECD-CS kidneys. The use of PP, by decreasing the incidence of DGF, may possibly lead to lower overall costs and increased utilization of donor kidneys.

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“…Adenosine 2A receptors (A 2A Rs) are a subtype of the G proteincoupled receptor family of adenosine receptors, which also includes A 1 R, A 2B R, and A 3 R (6, 7), and they have tissue protective properties (8). Systemically administered A 2A R agonists have been shown to reduce tissue injury associated with ischemia-reperfusion (9 -12).…”

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confidence: 99%

“…A 2A R agonists, including ATL313, attenuate IFN-␥ and limit anti-CD3e mAb-induced T cell activation (15). Delayed graft function is a form of IRI that is thought to increase the immunogenicity of the transplanted allograft (8) in part due to an increase in MHC class I and II expression leading to episodes of acute rejection and chronic graft loss. These findings suggest that A 2A Rs may be uniquely suited to block T cell activation associated with IRI and delayed graft function.…”

mentioning

confidence: 99%

Activation of Adenosine 2A Receptors Attenuates Allograft Rejection and Alloantigen Recognition

Sevigny¹,

Li²,

Awad³

et al. 2007

The Journal of Immunology

128

101

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The current studies investigated the in vitro and in vivo effect of adenosine 2A receptor (A2AR) agonists to attenuate allogenic immune activation. We performed MLRs with spleen T lymphocytes and APCs isolated from wild-type and A2AR knockout mice of both C57BL/6 and BALB/c background strains. Two-way MLR-stimulated T cell proliferation was reduced by ATL313, a selective A2AR agonist in a dose-responsive manner (∼70%; 10 nM), an effect reversed by the A2AR antagonist ZM241385 (100 nM). By one-way MLRs, we observed that ATL313’s inhibitory effect was due to effects on both T cells and APCs. ATL313 suppressed the activation markers CD25 and CD40L and the release of inflammatory cytokines IFN-γ, RANTES, IL-12P70, and IL-2. ATL313 also increased negative costimulatory molecules programmed death-1 and CTLA-4 expressed on T cells. In lymphocytes activated with anti-CD3e mAb, ATL313 inhibited the phosphorylation of Zap70, an effect that was reversed by the protein kinase A inhibitor H-89. In skin transplants, allograft survival was enhanced with ATL313, an effect blocked by ZM241385. These results indicate that A2AR agonists attenuate allogenic recognition by action on both T lymphocytes and APCs in vitro and delayed acute rejection in vivo. We conclude that A2AR agonists may represent a new class of compounds for induction therapy in organ transplantation.

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Delayed graft function in kidney transplantation

Cited by 836 publications

References 131 publications

Incidência e fatores de risco para complicações infecciosas no primeiro ano após o transplante renal

Incidência e fatores de risco para complicações infecciosas no primeiro ano após o transplante renal

Pulsatile Perfusion Reduces the Incidence of Delayed Graft Function in Expanded Criteria Donor Kidney Transplantation

Activation of Adenosine 2A Receptors Attenuates Allograft Rejection and Alloantigen Recognition

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