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Titolo:
RISK-FACTORS FOR LATE RECURRENT REJECTION AFTER HEART-TRANSPLANTATION- A MULTIINSTITUTIONAL, MULTIVARIABLE ANALYSIS
Autore:
KUBO SH; NAFTEL DC; MILLS RM; ODONNELL J; RODEHEFFER RJ; CINTRON GB; KENZORA JL; BOURGE RC; KIRKLIN JK; MCGIFFIN DC; WEISS T; CROSSWY A; AUSTIN B; EARLY L; HOLMES P; VEAZEY M; SIMS P; PRITZKER MR; LAKE KD; JORGENSEN CR; REUTZEL TJ; OKANE M; PEDERSEN W; JOYCE LD; EALES F; EMERY RW; VONREUDEN T; HOFFMAN F; SEIMERS N; BRUHN P; HEILMAN KJ; PACHECO D; BALLITY L; GRIEGO C; VENTURA HO; SMART FW; STAPLETON DD; VANMETER CH; DUMASHICKS D; BEIER RJ; TOUPS TS; CASSIDY CA; YOUNG JB; FARMER JA; COCANOUGHER B; LANTHIER S; MUDGE GH; JARCHO J; JOHNSON P; LOH E; HOBBS RE; JAMES KB; BOTTSILVERMAN C; RINCON G; STEWARD R; STEWART P; MCCARTHY P; PLATT L; PELEGRIN D; HOERCHER K; BROZENA SC; FITZPATRICK JM; GASH AK; MORLEY D; CHOJNOWSKI D; KOZAK J; STUTMAN P; TWOMEY C; STINSON D; LEVINE TB; LEVINE AB; NARINA B; BOEHMER J; DAVIS D; FRAZIER P; ULSHAFER A; DARROCA A; HILES L; BILLS RG; DARRAGH RK; CALDWELL RL; FLASPOHLER T; THOMPSON L; PELLETIER GB; COSTANZO MR; JOHNSON M; KAO W; MULLEN GM; EDWARDS BS; OLSEN LJ; FRAUTZ RP; DALY RC; MCGREGOR CM; IBRAHIM H; SNEED G; VANBAKEL AB; CRUMBLEY AJ; MCFADDEN C; WEST C; PITTS DE; KIRLIN P; HOLLBROOK H; WALLACE L; MITCHELL S; KEMP L; PORTER CB; BORKON AM; BRESNANHAN DR; GENTON RE; LONG ND; ROWE SK; RUSSELL EH; JANSEN DE; CORRIGAN VE; BIGGS L; FRENIER J; DAVIS P; JASKI BE; BRANCH K; MILLER LW; JENNISON SH; NOEDEL N; MASSIN EK; FRAZIER OH; RADOVANCEVIC B; SAMUELS W; POWERS P; SPOTO E; BRAUNER L; PINA IL; BOVE AA; JEEVANANDAM V; TODD B; MCCLURKEN JB; YANCY CW; JOHNSON N; MARTIN C; HORN VPH; RING WS; KAISER P; BALWIN BJ; WHITEWILLIAMS C; BLOOD P; BRELAND J; SCHLEY D; KEMEN R; SELMAN S; MCGINN C; WALKER T; CORDES B; POOSER J; BRAUNLIN E; DIEHL S; FRANCIS GS; BANK AJ; SHUMWAY SJ; BOLMAN RMB; ORMAZA S; MONSON K; DIEKMAN R; OROURKE M; STRASBURG K; FISHBEIN DP; KRUSE AP; HIMES VE; PASQUE MK; HUDDLESTON CB; ROSENBLOOM MR; EMMERT P; HENSHEID J; SAFFITZ JE; GOLDSTEIN JA; ROMERO CA; BEHRANDS C; RICHARDSON C;
Indirizzi:
UNIV MINNESOTA,HEART FAILURE HEART TRANSPLANTAT PROGRAM,UMHC BOX 508,420 DELAWARE ST SE MINNEAPOLIS MN 55455
Titolo Testata:
The Journal of heart and lung transplantation
fascicolo: 3, volume: 14, anno: 1995,
pagine: 409 - 418
SICI:
1053-2498(1995)14:3<409:RFLRRA>2.0.ZU;2-W
Fonte:
ISI
Lingua:
ENG
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Science Citation Index Expanded
Science Citation Index Expanded
Citazioni:
NO
Recensione:
Indirizzi per estratti:
Citazione:
S.H. Kubo et al., "RISK-FACTORS FOR LATE RECURRENT REJECTION AFTER HEART-TRANSPLANTATION- A MULTIINSTITUTIONAL, MULTIVARIABLE ANALYSIS", The Journal of heart and lung transplantation, 14(3), 1995, pp. 409-418

Abstract

Background: Previous studies of allograft rejection have focused on early episodes and risk factors from pretransplant variables. Methods: This multiinstitutional study compared early (<1 year) and late (>1 year) rejection episodes and risk factors for recurrent rejection from variables both before and after transplantation among 1251 patients whounderwent primary heart transplantation and available follow-up of greater than 1 year. Results: There were a total of 1882 rejection episodes over a mean follow-up of 26 +/- 0.3 months. The hazard function (instantaneous risk per patient per month) peaked at 1 month followed bya low constant risk of rejection after 12 months. By multivariable analysis, the most dominant risk factors for recurrent rejection during the first posttransplantation year were a shorter time interval since transplantation and a shorter time since a previous rejection episode. Other factors included young age, female gender, female donor, positive cytomegalovirus serology, prior infections, and OKT3 induction. In contrast, after the first year, the dominant risk factors for rejection were a greater number of rejections during the first year and the presence of prior cytomegalovirus infections. Conclusions: These data show a striking time dependency for rejection episodes among heart transplant recipients. Factors that increase risk for rejection in the first year differ from risk factors for rejection in subsequent years. These data suggest that it may be possible to tailor rejection surveillance protocols and immunosuppression intensity, according to specific patient and time-related risk factors.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 04/04/20 alle ore 14:24:36