Renal Transplant Registry Research Articles

Single-center 1-15-year results of renal transplantation in patients with systemic lupus erythematosus.

Initially, poor long-term prognosis in patients with SLE and fear of recurrent disease dissuaded renal transplantation in this group of patients. However, in 1975 the Advisory Committee to the Renal Transplant Registry reported satisfactory 1-2-year results in 56 patients with SLE from 36 institutions. Subsequently, renal transplantation for SLE patients with end-stage renal disease has become more accepted, though it has been recommended that transplantation be postponed for at least one year after initiating dialysis. Five cases of recurrent lupus nephritis have been reported in the literature. However, since the long-term outcome after transplantation in this group of patients is not well established, we have examined the long-term outcome in SLE patients who underwent renal transplantation at the University of Minnesota. Thirty-two SLE patients receiving 33 transplants between December 1969 and December 1987 were studied retrospectively and compared with controls matched for age, sex, donor source, HLA match, date of transplant, and diabetic status. A total of 69% (22/32) of patients underwent less than 1 year of dialysis prior to transplantation, and 50% (16/32) experienced biopsy-proved acute rejection, which was reversible in 67% (11/16). Actuarial graft function and patient survival rate in SLE patients were not significantly different from those in the matched control group. Duration of prior dialysis did not affect outcome. Surviving grafts have excellent function as measured by serum creatinine (1.3 +/- 0.4 mg/dl, means +/- SD). Causes of death were sepsis (5) and myocardial infarction (1). One patient lost the graft from rejection after withdrawal of immunosuppression because of a malignancy one month posttransplant. Three patients lost graft function due to chronic rejection. To date no patients have had evidence of recurrent SLE nephritis.

Preliminary results—Ashi historic positive cross-match renal transplant registry : Nancy E. Goeken; VA Medical Center, Iowa City, IA

Preliminary results—Ashi historic positive cross-match renal transplant registry : Nancy E. Goeken; VA Medical Center, Iowa City, IA

Recent Advances in Renal Transplantation

Recent Advances in Renal Transplantation

The renal transplant: Rejection and acute tubular necrosis

ENAL R allograft transplantation has in many instances become the preferred treatment for the patient in chronic renal failure. Although the immunologic factors that permit renal transplantation are still incompletely understood, and although its complications are numerous and often serious, kidney transplantation is preferable to chronic hemodialysis for many patients. The major posttransplantation problem is organ rejection. Rejection episodes are common, with an incidence as high as 93% when cadaveric kidneys are used. The cumulative statistics of the 1976 Renal Transplant Registry (19,631 patients) indicate that 68% of all patients who have received transplants are alive; in 45% the grafts are functioning, and in 23% the grafts are not functioning or have been removed. Of the remaining 32% of transplanted patients who have died, at the time of death 2 1% had a functioning graft and 11% did not. The transplantation results over the last several years at the Downstate Medical Center show a 42% 2-year functional survival of cadaveric grafts. Live related donor transplantatior is more successful, with an overall 2-year fu~lctional survival of 64%. When perfect histocompatibility has existed, 2-year functional survival has been 75 %. ‘.y A second and equally important complication that essentially is restricted to patients receiving cadaveric allografts is acute tubular necrosis. Factors such as the donor source, the modality of harvesting and preserving the kidney, and the operative technique influence the incidence of acute tubular necrosis, which ranges from 5 % to 75 %. 1.2 Since the majority of renal transplantations

Recent Advances in Clinical and Experimental Transplantation

THE SIXTH International Congress of the Transplantation Society was characterized by a recrudescence of interest in the various aspects of transplantation biology and medicine, and particularly in cell-to-cell interaction. The general consensus at the close of the meeting was that a firm basis had been established for the acquisition of new biological facts of direct relevance, not only to transplantation, but also in the understanding of a wide variety of disease processes in man. <h3>CLINICAL AND EXPERIMENTAL ORGAN TRANSPLANTATION</h3> The 13th (and final) report of the International Human Renal Transplant Registry of The American College of Surgeons, National Institutes of Health, was one of the highlights of the Congress. This report detailed the experience with 24,193 kidney transplants performed at 301 institutions, including 165 in the United States, since 1963. Six institutions performed more than 51 transplants per year in each of the five years ending in June 1976; eight

The Organ Donor

OF THE newer medical techniques, organ transplantation has most consistently intrigued the public. From the news of the first heart transplant to the most recent pancreatic islet transplants, the press has informed an interested public even before medical journals have informed physicians. When a kidney transplant recipient returns to his hometown after the surgery, he is at once a noted figure. Even strangers speak to him. However, the person that almost no one asks about is the donor. <h3>Donor Selection</h3> There are a large number of potential candidates for kidney transplantation each year. It is estimated that 50,000 to 55,000 patients in this country die each year of chronic renal failure. Dialysis and transplant can prolong the lives of many of these.¹ According to "The 12th Report of the Human Renal Transplant Registry,"²a total of 16,444 kidney transplants thus far are registered worldwide. Of these, 57% are

Tumors of the Bladder in Renal Transplant Patients: Report of a Case of Adenocarcinoma and Review of Known Cases

A case is presented of adenocarcinoma of the bladder in a 36-year-old man who had undergone renal transplantation 4 years previously. Treatment was cystectomy and ileal loop diversion.A review of the known cases of bladder tumors obtained from the literature and from the Human Renal Transplant Registry is discussed. The 8 cases presented include 4 transitional cell carcinomas, 1 squamous cell carcinoma, 1 nephrogenic adenoma and 2 adenocarcinomas. The unusual occurrence of adenocarcinoma in young male subjects is noted.

Nephrology: An Annotated Bibliography of Recent Literature

Nephrology: An Annotated Bibliography of Recent Literature

The 12th Report of the Human Renal Transplant Registry. Prepared by the Advisory Committee to the Renal Transplant Registry

This report, the 12th, from the Renal Transplant Registry summarizes current results of kidney transplantation in man. There has been a trend toward increasing use of cadaveric sources for kidney transplantation. Results are summarized in five-year life-table analyses of recipient survival and graft function. Also, a summary of the results of special studies is provided. These include preparation of the recipient for transplantation by nephrectomy in various disease states, comparison of simple flushing with machine perfusion in cadaveric kidney storage, results of transplantation in the pediatric recipient, and the development of malignant neoplasm in graft recipients. A large study relating typing to graft function presents information at some variance from previous reports published in the United States.

The 12th Report of the Human Renal Transplant Registry

The 12th Report of the Human Renal Transplant Registry

Renal Transplants From Cadaver Donors

An editorial in an earlier issue ofThe Journal(226: 1226, 1973) stated that, in contrast to other organ transplantation procedures, renal transplantation has passed the experimental and entered the therapeutic stage. That same issue carried The 11th Report of the Human Renal Transplant Registry (226:1197-1204, 1973) in which cadaver donors had come to comprise 63.4% of renal grafts reported to the registry. That percentage is misleading unless the reader understands that the registry is international. In the United States, cadaver donors provided only 52.6% of grafts whereas in Europe 78.8% and in Australasia 98.3% of renal grafts came from cadavers. In this issue ofThe Journal(p 882), Chatterjee et al describe their experience with efforts to obtain postmortem donor kidneys. During the period April 1973 to April 1974, eight-six patients were referred to the Los Angeles County—University of Southern California Medical Center as potential postmortem kidney donors under

Renal transplantation in congenital and metabolic diseases. A report from the ASC/NIH renal transplant registry

Renal transplantation in congenital and metabolic diseases. A report from the ASC/NIH renal transplant registry

The 11th report of the human renal transplant registry

This 11th Report from the Renal Transplant Registry updates and extends a profile view of the natural history of a renal transplant and, in addition, comments on selected topics that have become increasingly important since the last report.¹ The Renal Transplant Registry operates under sponsorship of the American College of Surgeons and receives funding from several cooperating institutes of the National Institutes of Health. The present registry and its advisory committee are direct descendants of the Kidney Transplant Registry founded in Boston in 1963 and capably operated there for several years by Drs. Joseph E. Murray and Benjamin A. Barnes. That the registry exists at all is testimony to the vision of these investigators and the cultivation by them of a spirit of cooperation and experience-sharing with other transplantors that has allowed accumulation of registry data over subsequent years. It is recognized that the 246 institutions that report to

The 11th Report of the Human Renal Transplant Registry

This 11th Report from the Renal Transplant Registry updates and extends a profile view of the natural history of a renal transplant and, in addition, comments on selected topics that have become increasingly important since the last report.¹ The Renal Transplant Registry operates under sponsorship of the American College of Surgeons and receives funding from several cooperating institutes of the National Institutes of Health. The present registry and its advisory committee are direct descendants of the Kidney Transplant Registry founded in Boston in 1963 and capably operated there for several years by Drs. Joseph E. Murray and Benjamin A. Barnes. That the registry exists at all is testimony to the vision of these investigators and the cultivation by them of a spirit of cooperation and experience-sharing with other transplantors that has allowed accumulation of registry data over subsequent years. It is recognized that the 246 institutions that report to

Successful Renal Transplantation in Systemic Lupus Erythematosus.

Meeting Abstracts1 May 1973Successful Renal Transplantation in Systemic Lupus Erythematosus.Kathryn L. Popowniak, M.D., Satoru Nakamoto, M.D., William E. Braun, M.D., Ray W. Gifford Jr., M.D., F.A.C.P., Ralph Straffon, M.D.Kathryn L. Popowniak, M.D.Search for more papers by this author, Satoru Nakamoto, M.D.Search for more papers by this author, William E. Braun, M.D.Search for more papers by this author, Ray W. Gifford Jr., M.D., F.A.C.P.Search for more papers by this author, Ralph Straffon, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-78-5-828_4 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptPatients with systemic lupus erythematosus have been considered poor candidates for renal transplantation because of the multisystem involvement of the disease. As of 1 October 1972, the Human Renal Transplant Registry reported that only 38 patients with this disease had been transplanted in the United States since 1963. During the past 9 years six patients, aged 18 to 44 years, with systemic lupus erythematosus have received renal transplants at the Cleveland Clinic. All had end-stage renal failure requiring intermittent hemodialyses.Immunosuppressive therapy consisted of azathioprine, 5 mg/kg of body weight, on the day of surgery and a maintenance dose of... This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: Cleveland, Ohio. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 May 1973Volume 78, Issue 5Page: 828-829KeywordsBody weightImmunosuppressivesLupus erythematosusRenal diseasesRenal failureRenal transplantationSurgerySystemic lupus erythematosus Issue Published: 1 May 1973 PDF DownloadLoading ...

The tenth report of the human renal transplant registry

The tenth report of the human renal transplant registry

The Tenth Report of the Human Renal Transplant Registry

The Tenth Report of the Human Renal Transplant Registry

The ninth report of the Human Renal Transplant Registry

The ninth report of the Human Renal Transplant Registry

The Ninth Report of the Human Renal Transplant Registry

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Renal transplantation--1972.

Excerpt The major conclusion one must draw fromThe Ninth Report of the Human Renal Transplant Registry(1) is that since 1966 there has been no significant improvement in patient survival or duratio...