Late Graft Loss

In all varieties of organ transplants, early results have dramatically improved over the past two decades and failures due to acute rejection are becoming rarer. Efficient immunosuppressive regimens have been developed with the objective of very good results at 1, 3 and 5 years.
Successful transplants, however, are significantly less frequent at 10 and 20 years, and many patients require retransplantation. Many factors are involved in late graft loss and it is now well recognized that, in addition to chronic rejection, a number of non-immunologic factors play a prominent role. In the case of renal transplantation, a reduced mass loss (transplantation of a single kidney, sometimes from an aged donor, ischemic injury and alteration of some nephrons in the case of early acute rejection) will result in slowly progressing chronic renal failure, even in the absence of any supplementary attack of an immunological nature. The new treatments must be analyzed in the light of their capacity to reduce these late failures. Several preventive measures can also limit both immunologic and non-immunologic factors of late transplant deterioration.

Inhalt

1. Chronic graft loss in kidney and heart transplant recipients.- 2. Histopathology of chronic rejection.- 3. Evaluation of biopsy changes in the early diagnosis of chronic transplant nephropathy.- 4. Is there any relationship between the early glomerular filtration rate and late graft dysfunction in renal transplantation?.- 5. Transplantation atherosclerosis: Definition and pathogenesis.- 6. Immunological mechanism of chronic rejection.- 7. The role of adhesion molecules in chronic rejection.- 8. A role for TH2 cells in chronic allograft rejection?.- 9. Treatment of refractory acute allograft rejection with aerosolized cyclosporin in lung transplant recipients.- 10. Ischemia-reperfusion injury as a risk factor for late kidney graft failure.- 11. The impact of acute rejection in the longterm outcome after renal transplantation.- 12. Nephron endowment and the pathogenesis of chronic renal failure.- 13. Are child donors better than adult donors for pediatric kidney recipients?.- 14. Late graft loss in combined kidney-pancreas transplantation.- 15. Longterm allograft outcome in patients treated with prophylactic antilymphocyte globulin or OKT3 as induction therapy in cadaveric kidney transplantation.- 16. Cyclosporin - longterm treatment.- 17. Effect of new immunosuppressive drugs on chronic rejection.- 18. Experimental transplantation in rats for the study of the pathogenesis and treatment of chronic rejection.- 19. The effects of HMG-CoA reductase inhibitors after kidney and heart transplantation: Lipid lowering and immunosuppression.- 20. Lipid metabolism alteration and treatment in heart transplant recipients.- 21. Prevention and treatment of cytomegalovirus (CMV) disease.- 22. Longterm renal function protection in renal transplantation by nonimmunological treatments.- Clinical impact and predictive role of OGTT as a marker of longterm loss of function in patients submitted to pancreas transplantation.- Influence of recipient - donor body weight ratio in pediatric renal transplantation.- Survival, rejection, tumors and infections 5 years after liver transplantation.- Comparison of dipyridamole thallium scintigraphy and dobutamine stress echocardiography to detect graft coronary artery disease in heart transplant patients.- Immunohistochemical profile in asymptomatic acute rejection of renal allografts: Predictive marker of graft loss.- High sodium UW cold-storage solution improves kidney graft function in rats.- Influence of natural selection haplotypes on longterm survival in renal transplantation from haploidentical living related donors.- Posttransplant immunological monitoring by ELISA: HLA-specific IgG antibodies are associated with early and late graft loss events.- Longterm benefit of additional azathioprine in cyclosporin/prednisolone-treated patients with chronic renal allograft dysfunction.- Effect of steroid withdrawal on late immunologic complications after liver transplantation.- Effect of angiotensin converting enzyme inhibitors (ACEI) on the progressive graft failure and proteinuria in kidney transplant patients with chronic rejection.- ATG prophylaxis preoperatively reduced acute rejections - a predicting factor on long graft survival.- Kidney transplantation in children at our center.- Kidney transplantation between spouses.- Oxidative stress and lipid abnormalities during chronic rejection of kidney transplantation.- Proton NMR spectroscopy as a novel approach to the assessment of function in the pig isolated kidney exposed to cold ischemia.- Renal handling of citrate excretion during reperfusion after cold storage in the isolated perfused pig kidney.- The improvement of early rat kidney graft function after perfusion with HTK solution supplemented with pentoxifylline.- Nifedipine improves kidney function after 24 h cold storage in a high-sodium UW solution.- Preventing cadaveric grafted kidney from acute rejection with anti-thymocyte globulin.- Study of the pharmacokinetics of the Neoral® formulation of cyclosporin in vivo.- One-year results of the European mycophenolate mofetil phase III in clinical trial in renal transplantation.- Detection of lymphocyte panel reactive antibody (PRA) use in kidney transplantation.- Cholestatic and HCV-related liver disease associated with acute rejection after liver transplantation.- Outcome of children and adolescents with recurrent nephrotic syndrome (NS) and focal segmental glomerulosclerosis (FSGS) after renal transplantation.- CD8+ T lymphocytes can amount to a second-set rejection of skin allografts in the absence of cytotoxic antibodies.- Hyperimmune globulin in the prevention of cytomegalovirus infection: Lack of efficacy in kidney graft recipients.- Lung and heart lung transplantation: Survival data concerning 100 transplants carried out in 95 patients at the L. Pradel University Hospital, Lyon.- Evolution of lipoprotein(a) and concentration 6 months after a successful renal transplantation.- GSTs: Sensitive and specific markers for liver transplant monitoring.- Is overweight a relevant risk factor in the short- and longterm evolution of renal transplantation?.- Renal allograft thrombosis (rat): A case-control study.- A prospective study on the effect of kidney transplantation (KT) and cyclosporin treatment on male sexual performance and hormonal profiles.- Iliac artery histology and renal allograft blood flow measured by Doppler spectrum analysis.- Blood flow impairment in popliteal and posterior tibial arteries after iliac end-to-side anastomosed renal transplantation.- The first kidney transplantation from spouse in Lithuania.- Name Index.