Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0009443 (cold)
 92,137 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

1. The risks associated with nonbeneficial matching constitute a persistent hazard to the transplant over a long period. 2. The benefits of HLA matching and CsA are separate and additive. 3. There is no evidence that beneficial matching is not relevant to all (UK) centers. 4. Contemporary typing methods are expected to improve the accuracy of typing and reduce kidney cold-ischemia times. 5. Organ sharing increases the numbers of beneficial matches. 6. Patients with easily matchable ABO-HLA phenotypes should wait for beneficially matched transplants. 7. Patients with phenotypes that are difficult to match should be intelligently mismatched after due consideration of responder status, acceptable mismatches, and cross-reactive groups. 8. Organ sharing does not prejudice graft survival. 9. Wastage is minimized with a central clearing house. 10. Organ sharing reduces the incidence of high sensitization. 11. Organ sharing is cost effective. For these reasons we repudiate the view that organ sharing is now superfluous.
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PMID:In defense of organ sharing in kidney transplantation. 315 14

The salient features of one-year regraft transplant survival are as follows: 1. The effect of cyclosporine is less (about 7% increase in one-year graft survival) on regrafted patients than on first grafts. 2. In general we saw a HLA antigen matching effect in cyclosporine- and noncyclosporine-treated retransplant patients. 3. Patients who received living-related HLA two-haplotype matched kidneys did equally as well as a first or regraft recipient. 4. Transfusions seemed to have a minimal effect on regraft survival. 5. It is more important to match in patients who have PRA and the matching benefits translate into 61% and 75% one-year graft survival for zero DR and zero B,DR mismatched regraft patients, respectively. 6. In regrafts, female donor kidneys resulted in 15% lower one-year graft survival than male donor kidneys. 7. Retransplant patients from fair centers showed a significant 13% increase in one-year graft survival with cyclosporine. 8. Cold ischemia time, diabetes, and kidneys used locally or shipped had little effect on the regraft one-year survival. 9. The initial function of the retransplant kidney had a very large effect on the final one-year graft outcome of that kidney and was independent of the use of cyclosporine patients having a functioning kidney at one month had 75% and 72% one-year regraft survival with and without cyclosporine treatment, respectively. Patients having a nonfunctioning kidney at one month had 5% and 8% one-year regraft survival with and without cyclosporine treatment, respectively. 10. Responder and nonresponder classifications as defined by the duration of the first graft resulted in a 10 to 15% difference in regraft survival. 11. The effect of HLA-A,B matching was very strong in responder patients, i.e., there was a 32% difference in one-year regraft survival between zero mismatch and more than two antigens of mismatch. In nonresponder patients, the effect of HLA-A,B matching was only 5%. For HLA-DR locus matching, the difference was 12% for responders and 6% for nonresponders. 12. Cyclosporine use showed about a 10% increase in graft survival in responders and nonresponders. 13. Responder classification was also possible by separating patients who had initial function but no function at one month (responders) from those with function at one month (nonresponders).
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PMID:Regraft kidney transplant survival. 315 19

1. Kidneys from female donors between the ages of 31 and 50 had consistently poorer graft survival rates than kidneys from male donors or younger female donors. 2. Sensitized first cadaver kidney recipients of older female donor kidneys had a one-year graft survival rate of 65% as compared with 82% in recipients of young male donor grafts (p less than 0.001). Retransplanted recipients of older female donor grafts had a one-year graft survival rate of 48% as compared with 70% in recipients of young male donor kidneys (p less than 0.001). 3. The effects on graft survival of donor age and sex were considerably greater than the effect of cold ischemia in excess of 36 hours. 4. The cause of donor death was a risk factor for sensitized and regraft recipients. In data from 45 transplant centers, sensitized first transplant recipients of nontrauma donor kidneys had a one-year graft survival rate of 67% versus 78% (p = NS) for recipients of trauma donor kidneys. Regraft recipients of nontrauma donor grafts had a one-year graft survival rate of 55% versus 67% (p less than 0.05) for recipients of trauma donor kidneys. 5. The cause of donor death effect and the effects of donor age and sex may be related as older female donors accounted for 37% of nontrauma donors and only 7% of trauma donors were older females. 6. A surprisingly high percentage of older female (6%) and nontrauma donor kidneys (3%) failed on the first day posttransplant in regrafted patients. A very sensitive crossmatch may help reduce the number of immediate failures. 7. HLA matching improved graft survival of female donor kidneys to a greater extent than male donor kidneys in regrafted patients. With zero or one mismatch at HLA-B,DR there was no difference in one-year graft survival between male and female donor kidneys. In first cadaver transplants, the difference in graft survival between older female and young male donor grafts was minimized by very good matching. Matching also abrogated the donor sex and age effects in living-related donor transplants. 8. Sensitized patients and patients who have previously rejected a kidney should be given priority for young male trauma donor organs when these become available.
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PMID:Donor factors. 315 42

1. In this prospective study of 613 CD and 205 one haplotype mismatched LRD transplant recipients treated with CyA, there was no influence of HLA-matching (A, B, DR or combinations) on graft survival rate at one and two years. 2. Patients who successfully received HLA-DR-matched kidneys (CD or LRD) had fewer rejection episodes during the first six months after transplantation. 3. Three factors significantly reduced the cadaveric graft survival rate: (a) presence of panel reactive T-cell antibodies in a current recipient serum, (b) cold ischemia time beyond 27 hours, and (c) recipient age above 55 years. 4. The survival rate of one haplotype mismatched LRD kidneys was excellent and is considered to be the optimal treatment for uremia also in CyA-treated patients. 5. Based on this study, exchange of well HLA-matched CD kidneys to non-sensitized patients has been terminated provisionally in Scandia-transplant. Exchange of HLA-A, B-matched kidneys will be maintained, however, for sensitized patients inasmuch as this will increase the chance of obtaining a negative cross-match and possibly improve graft survival in this high-risk patient group.
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PMID:HLA-matching in cyclosporine treated renal transplant recipients: a prospective Swedish-Norwegian multicenter study. 315 55

1. In transplants performed between 1971 and 1986, first cadaver donor grafts had a half-life ranging from 6.6 to 7.5 years in the period after the first year. Second cadaver donor grafts had a half-life of 5.1 to 6.5 years. Parental donor grafts had a half-life of 9.3 to 11.8 years, whereas HLA identical sibling donor transplants had a half-life of 19.1 to 26.5 years. Siblings with no haplotype in common had an average half-life of 8.7 years. 2. Between 1971 and 1984, white recipients had an average half-life of 7.7 years, which increased to 9.3 years in 1985-1986. Black recipients' half-life decreased from 5.4 years in 1975-1976 to 3.5 years in 1985-1986. The reason for this decrease is not apparent. 3. The half-life of transplants of different recipient ages did not vary significantly. The average half-life during this period of study was 7.4 years for those younger than 21 years of age, 8.2 years for recipients 21 to 50 and 6.7 years for those older than 50. 4. In the early data, there was some evidence that the half-life of kidneys with cold ischemia below 13 hours was superior. However, in the latest period (between 1983 and 1986) the average half-life was 7.6 years for CIT below 13 hours, 7.2 years for those with 13 to 24 hours and 6.4 years for more than 24 hours. 5. For patients receiving kidneys with no HLA-A,B mismatches, the average half-life was 10.1 years. Those with A,B mismatches had a half-life of 6.7 years, and for those with no A,B antigens in common, the average half-life was 6 years. 6. In the period after 1981, the average half-life of patients with no A,B,DR mismatches was 9.1 years compared with 6.5 years for those with A,B,DR mismatches and 5.4 years for those with no A,B,DR antigens in common.
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PMID:Long-term survival. 315 79

The susceptibility of human neuroblastoma cells to direct cellular cytotoxicity has not been previously established. This is of particular interest because of their aggressive growth and low HLA expression. Neuroblastoma lines CHP 100 and CHP 126 were found to be excellent targets in 4-hr CML assays. Natural killer (NK) cells from fresh PBL and from an NK clone, 3.3, have high lytic activity against both cell lines. We also studied mixed lymphocyte culture-generated cytotoxic lines containing allo-specific cytotoxic T lymphocytes (CTL) directed against HLA antigens present on the neuroblastoma target cell lines. These lines did show excellent lytic activity, but cold target competition studies indicated that all of the lysis resulted from NK activity. This was verified by using inhibition studies with the use of monoclonal antibodies. OKT 3 and anti-HLA antibodies that block CTL function caused no reduction in kill. In contrast, anti-lymphocyte function antigen-1 (anti-LFA-1), which blocks both NK and CTL function, significantly inhibited lysis. These results serve as a functional confirmation of earlier findings of a very weak expression of HLA-A,B,C and beta 2-microglobulin on neuroblastoma cells.
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PMID:Human neuroblastoma cell lines are susceptible to lysis by natural killer cells but not by cytotoxic T lymphocytes. 315 2

HLA profiles of 25 donor-specific transfusion (DST) kidney donor-recipient pairs were analyzed for HLA antigen compatibility. Serum samples collected during and after DST were tested for cytotoxic antibodies against T and B lymphocytes of the donors and 30 normal individuals. Eleven recipients did not produce cytotoxic antibodies to the antigens of their DST donors, and eight produced cold and/or warm, broadly reactive B-cell antibodies. Six patients (24%) produced HLA-A, B, C, and/or DR antibodies. Three of these individuals produced antibodies after two immunizations, while others required three immunizations. Three of the 11 antibody nonproducers (17%) had not received previous transfusions, as compared to three of the eight antibody producers (43%). Comparison of HLA profiles revealed 22 percent of the HLA-A, B, DR identities between the transfusion donor and recipient in antibody nonproducers as compared to 9 percent of the HLA-A, B, DR identities in antibody producers. The HLA-A2, B40, DR4 haplotype and HLA-DRW6 antigen were more common among antibody producers than among nonproducers, who had an excess of the HLA-B8, DR3 haplotype. These results are consistent with the hypothesis that there may be high- and low-responder HLA haplotypes that control immunologic responsiveness to histocompatibility antigens.
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PMID:Donor-specific transfusions. Donor-recipient HLA compatibility, recipient HLA haplotype, and antibody production. 328 35

Whether kidneys from cadaver donors should be exchanged among transplant centers is controversial. We analyzed the effect of matching for HLA-B and HLA-DR antigens on graft survival in patients treated with cyclosporine. The results in 9369 recipients of kidneys obtained and transplanted in the same center were compared with those in 5553 recipients of kidneys shipped from one center to another. In both patient subgroups, the association of HLA matching with graft survival was statistically significant (P less than 0.0001). Moreover, well-matched exchanged kidneys survived better than poorly matched locally transplanted kidneys. Among patients receiving their first cadaver transplant, graft survival at one year was 13 percentage points higher (P less than 0.0001) in exchanged kidneys without mismatches than in local kidneys with four mismatches. Among patients receiving their second transplant, graft survival was 21 percentage points higher (P less than 0.001). Kidney preservation for up to 48 hours did not affect graft survival significantly. Transplantation of poorly matched local kidneys preserved with a short period of cold ischemia (less than 24 hours) had significantly lower rates of success than did transplantation of well-matched exchanged kidneys with a longer period of cold ischemia (up to 48 hours) (P less than 0.0001). Our data indicate that the exchange of cadaver kidneys among transplant centers to obtain grafts with better HLA matching can improve the success rate of renal transplantation.
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PMID:The benefit of exchanging donor kidneys among transplant centers. 328 57

Low-affinity, cold-reactive antibodies easily removed by washing were not detected by the antiglobulin technique but killed T lymphocytes when washing was omitted, incubation was prolonged, and cytotoxic tests were incubated at room temperature or at 4 degrees C. These antibodies were present in approximately 25% of sera from dialysis patients. Only a subset of such sera (22%) reacted with autologous lymphocytes. The majority (86%) appeared to detect non-HLA antigens. A small number (14%) detected class I HLA antigens. Two patients transplanted with antiglobulin-negative, T-warm-negative crossmatch results, but positive cytotoxicity after a 2-hr incubation without washing, rapidly lost their grafts (less than 1 month) due to rejection. Their sera contained antibodies against non-HLA alloantigens expressed on lymphocytes and platelets, but not on granulocytes or erythrocytes. Two other patients with positive autoantibody tests exhibiting similar crossmatches with the current serum were transplanted recently. Both of them retain their grafts with good function at one month. In two other cases, the recipients were unreactive against the donor in current serum but displayed an antiglobulin-negative, 2-hr cytotoxicity-positive pattern in a previously drawn serum specimen. One patient continues to have stable renal function after 10 months. The other patient lost the transplant as a result of renal artery thrombus thought not to be immunologic in origin. Work is continuing to define the specificity and determine the clinical relevance of such cold-reactive antibodies.
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PMID:Kidney transplant recipients with long incubation-positive antiglobulin-negative T cell crossmatches. 331 40

Sixty-seven pairs of HLA matched siblings, each comprising marrow donor and recipient in the Seattle marrow transplant program, were analyzed to establish phenotype for a newly described minor H antigen, W1. The test for phenotype entailed cold target inhibition of cytotoxicity, directed at this antigen and mediated by specifically stimulated T cell lines. There were 58 compatible and six W1 incompatible pairs. The low frequency of W1 mismatch is due to the strong preponderance of W1-positive individuals in the general population. Severe graft-versus-host disease (GVHD), both acute and chronic, was observed among the 58 recipients of marrow from W1 matched donors. These results do not reveal any particular importance for W1 incompatibility in human GVHD and indeed indicate that other systems are involved. Even if some cases are triggered by incompatibility at W1, the maximum frequency with which this could occur would be about 10%, due to the limited polymorphism of this alloantigenic system.
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PMID:Study of a human minor alloantigen in relation to clinical graft-versus-host disease. 333 47


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