Your browser doesn't support javascript.
loading
Show: 20 | 50 | 100
Results 1 - 2 de 2
Filter
Add more filters










Database
Language
Publication year range
1.
Transpl Int ; 33(9): 1128-1139, 2020 09.
Article in English | MEDLINE | ID: mdl-32479670

ABSTRACT

Anti-HLA-antibody characteristics aid to risk-stratify patients and improve long-term renal graft outcomes. Complement activation by donor-specific antibody (DSA) is an important characteristic that may determine renal allograft outcome. There is heterogeneity in graft outcomes within the moderate to high immunological risk cases (cross-match-positive). We explored the role of C3d-positive DSAs in sub-stratification of cross-match-positive cases and relate to the graft outcomes. We investigated 139 cross-match-positive living-donor renal transplant recipients from four transplant centres in the United Kingdom. C3d assay was performed on serum samples obtained at pretreatment (predesensitization) and Day 14 post-transplant. C3d-positive DSAs were found in 52 (37%) patients at pretreatment and in 37 (27%) patients at Day 14 post-transplant. Median follow-up of patients was 48 months (IQR 20.47-77.57). In the multivariable analysis, pretreatment C3d-positive DSA was independently associated with reduced overall graft survival, the hazard ratio of 3.29 (95% CI 1.37-7.86). The relative risk of death-censored five-year graft failure was 2.83 (95% CI 1.56-5.13). Patients with both pretreatment and Day 14 C3d-positive DSAs had the worst five-year graft survival at 45.5% compared with 87.2% in both pretreatment and Day 14 C3d-negative DSA patients with the relative risk of death-censored five-year graft failure was 4.26 (95% CI 1.79, 10.09). In this multicentre study, we have demonstrated for the first time the utility of C3d analysis as a distinctive biomarker to sub-stratify the risk of poor graft outcome in cross-match-positive living-donor renal transplantation.


Subject(s)
Kidney Transplantation , Graft Rejection , Graft Survival , HLA Antigens , Humans , Isoantibodies , Risk Assessment , Tissue Donors , United Kingdom
2.
Nurs Stand ; 17(6): 51-4, 56, 2002 Oct 23.
Article in English | MEDLINE | ID: mdl-12434750

ABSTRACT

This article describes the care of a patient with oedematous legs. It examines the issues related to adapting compression therapy to suit this patient, so that she was in concordance with treatment, rather than rigidly following general recommended treatments. The case was complex but the outcomes justified the decisions and provided a rationale for future, similar, cases.


Subject(s)
Bandages/standards , Leg Ulcer/nursing , Aged , Aged, 80 and over , Bandages/classification , Female , Humans , Leg Ulcer/classification , Nursing Assessment/methods , Patient Selection , Physical Examination , Recurrence , Severity of Illness Index
SELECTION OF CITATIONS
SEARCH DETAIL
...