Başkent Üniversitesi Makaleler

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Subject: search.filters.subject.Graft loss

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    Posttransplant Soluble CD30 as a Predictor of Acute Renal Allograft Rejection
    (Başkent Üniversitesi, 2009-12) Ghadimi, Naime; Rezaie, Alireza R.; Kamali, Koosha; Abbasi, Mohammad Amin; Farokhi, Babak; Abbasi, Ata; Fallah, Parvane; Seifee, Mohammad Hasan
    Background: Recent results have indicated that high prerenal and postrenal transplant soluble CD30 levels may be associated with an increased acute rejection and graft loss. The aim of this study was to evaluate the feasibility of using serum sCD30 as a marker for predicting acute graft rejection. Materials and Methods: In this prospective study, we analyzed clinical data of 80 patients, whose pretransplant and posttransplant serum levels of sCD30 were detected by enzyme-linked immunoassay. Eight patients developed acute rejection, 7 patients showed delayed graft function, and 65 recipients experienced an uncomplicated course group. The patients were followed for 12 months, and there were no deaths. Results: Preoperative sCD30 levels of 3 groups were 96.2 ± 32.5, 80.2 ± 28.3, and 76.8 ± 29.8 U/mL (P = .28). After transplant, a significant decrease in the sCD30 level was detected in 3 groups on day 14 posttransplant (P < .001), while sCD30 levels of acute rejection group remained significantly higher than delayed graft function and nonrejecting patients (28.3 ± 5.2, 22.1 ± 3.2, and 19.8 ± 4.7 U/mL) (P = .02). Positive panel reactive antibody was not statistically different among groups (P = .05). Also, hemodialysis did not affect sCD30 levels (P = .05). Receiver operating characteristic curve demonstrated that the sCD30 level on day 14 posttransplant could discriminate patients who subsequently suffered acute allograft rejection (area under receiver operating characteristic curve, 0.95). According to receiver operating characteristic curve, 20 U/mL may be the optimal operational cutoff level to predict impending graft rejection (specificity 93.8%, sensitivity 83.3%). Conclusions: Measurement of the soluble CD30 level on day 14 after transplant might offer a noninvasive means for recognizing patients at risk of acute graft rejection during the early posttransplant period.
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    Strategies for Reducing the Renal Transplant Waiting List: A Review
    (Başkent Üniversitesi, 2009-09) Shrestha, Badri Man
    Renal transplant is the optimum form of therapy for most patients with end-stage renal failure, because that treatment results in a significant improvement in the patient’s quality of life and is cost-effective. The exponential increase in the number of patients on the renal transplant waiting list globally has become a serious problem fueled by an increase in the number of patients with end-stage renal disease, the shortage of organs for transplant, and the failure of transplanted kidneys for various reasons. Strategies are being used by transplant professionals to retard the progression of chronic kidney disease, increase organ donation, reduce the acute rejection rate, and prevent transplant losses. This paper provides an up-to-date review of the interventional strategies used to reduce the ever-increasing renal transplant waiting list.