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Renal Transplantation in High Immunological Risk Patients: A Single-Center Experience.
- Source :
-
Transplantation proceedings [Transplant Proc] 2019 Sep; Vol. 51 (7), pp. 2298-2301. Date of Electronic Publication: 2019 Aug 09. - Publication Year :
- 2019
-
Abstract
- Background: Renal transplantation (RT) in high-risk patients is increasingly performed due to an inadequate organ pool and increased rate of RT after a failed transplantation. Safety and prognosis of RT in such patients with high risk is an ongoing debate. Herein we aimed to present our single-center experience on RT of high-risk patients.<br />Methods: A total of 89 consecutive RT patients were included into this study in a 10-month period. Patients were divided into 3 groups: the low-risk group (n = 47) with negative panel reactive antibody (PRA), medium-risk group (n = 18) with positive PRA but mean fluorescence intensity (MFI) < 2000, and high-risk group (n = 24) with positive PRA and MFI >2000 or donor specific antibody (DSA) positivity. Groups were compared in terms of demographic features, serum creatinine levels, acute rejection rates, delayed graft function (DGF), and patient or graft loss.<br />Results: Age of the recipients were similar between the groups. Desensitization (7% vs 11% vs 42%, respectively, in low-, medium-, and high-risk groups; P = .001), plasmapheresis (6% vs 11% vs 46%, respectively, P < .001), and rituximab treatments (0% vs 0% vs 25%, respectively, P < .001) were significantly more frequently performed in high-risk patients. Serum creatinine levels at 1 month and 6 months after RT were similar between the groups (P = .43 and P = .71, respectively). Rates of acute rejection (6% vs 6% vs 16%, respectively, P = .52) and DGF (9% vs 11% vs 29%, respectively, P = .15) were similar between the groups. Frequencies of loss of patient or graft were also similar (0% vs 6% vs 4%, P = .15).<br />Conclusion: RT may be successfully performed in high-risk patients without an increase in the risk of acute rejection, DGF, or patient/graft loss.<br /> (Copyright © 2019. Published by Elsevier Inc.)
- Subjects :
- Adult
Antibodies immunology
Delayed Graft Function immunology
Female
Graft Survival immunology
Humans
Male
Middle Aged
Risk Factors
Desensitization, Immunologic statistics & numerical data
Graft Rejection immunology
Kidney Transplantation adverse effects
Plasmapheresis statistics & numerical data
Rituximab therapeutic use
Subjects
Details
- Language :
- English
- ISSN :
- 1873-2623
- Volume :
- 51
- Issue :
- 7
- Database :
- MEDLINE
- Journal :
- Transplantation proceedings
- Publication Type :
- Academic Journal
- Accession number :
- 31405734
- Full Text :
- https://doi.org/10.1016/j.transproceed.2019.04.075