| Effect of induction therapy protocols on transplant outcomes in crossmatch positive renal allograft recipients desensitized with IVIG. | |
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MedLine Citation:
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PMID: 16869794 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Here we retrospectively examine the efficacy of two antibody induction regimens using Zenapax or Thymoglobulin in patients with positive complement-dependent cytotoxicity crossmatches (CDC-CMXs) desensitized with IVIG (intravenous immunoglobulin). Between January 1999 and March 2005, 97 patients with (+) CDC-CMXs received kidney transplants (43 deceased donors/54 living donors). All patients received at least 2 g/kg IVIG (maximum four doses) until an acceptable CMX was obtained. Patients were divided into two groups: 1. IVIG + Zenapax (n = 58), 2. IVIG + Thymoglobulin (n = 39). A total of 94% of patients in Group 1 and 84% in G2 have at least 2 years of follow up. Patient and graft survival was 96%/84% in Group 1 and 100%/90% in Group 2, p = NS. The number and severity of AR episodes were similar (36% Group 1 vs. 31% Group 2, p = NS) as was the incidence of C4d (+) antibody-mediated rejection (AMR) (Banff Grade II/III) (22% Group 1 vs. 21% Group 2). Mean serum creatinines (SCrs) at 24 months were similar (Group 1: 1.4 +/- 0.7 vs. G2: 1.5 +/- 0.7 mg/dL). Induction therapy with Zenapax or Thymoglobulin results in excellent patient, graft survival and graft function at 2 years. There was no increased risk of viral infections or malignancies with either agent. Neither agent was effective in reducing the incidence of AMR. |
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Authors:
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A A Vo; M Toyoda; A Peng; S Bunnapradist; M Lukovsky; S C Jordan |
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Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't Date: 2006-07-25 |
Journal Detail:
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Title: American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons Volume: 6 ISSN: 1600-6135 ISO Abbreviation: Am. J. Transplant. Publication Date: 2006 Oct |
Date Detail:
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Created Date: 2006-09-14 Completed Date: 2006-12-19 Revised Date: 2007-02-14 |
Medline Journal Info:
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Nlm Unique ID: 100968638 Medline TA: Am J Transplant Country: Denmark |
Other Details:
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Languages: eng Pagination: 2384-90 Citation Subset: IM |
Affiliation:
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Comprehensive Transplant Center, Transplant Immunology Laboratory, Cedars-Sinai Medical Center, Los Angeles, California, USA. Ashley.Vo@cshs.org |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Acute Disease Adolescent Adult Aged Antibodies, Monoclonal / therapeutic use* Child Child, Preschool Drug Therapy, Combination Female Follow-Up Studies Graft Rejection / immunology, prevention & control* Graft Survival Histocompatibility Testing Humans Immunoglobulin G / therapeutic use* Immunoglobulins, Intravenous / therapeutic use* Immunologic Factors / therapeutic use* Immunosuppression / methods Immunosuppressive Agents / therapeutic use* Kidney Transplantation / immunology* Male Middle Aged Retrospective Studies Treatment Outcome |
| Chemical | |
Reg. No./Substance:
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0/Antibodies, Monoclonal; 0/Immunoglobulin G; 0/Immunoglobulins, Intravenous; 0/Immunologic Factors; 0/Immunosuppressive Agents; 0/thymoglobulin; 152923-56-3/daclizumab |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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