Study examines factors in pediatric kidney transplant rejection
2011-07-19
(Press-News.org) Avoiding HLA-DR mismatching appears to be beneficial in pediatric kidney transplant patients, however the likelihood of finding a matching donor must be considered against the wait time for a possible donation, according to a report in the July issue of Archives of Surgery, one of the JAMA/Archives journals.
"Although avoiding HLA [human leukocyte antigen; cell surface antigens that regulate host cell responses to transplanted cells] antigen mismatching has been shown to benefit long-term graft survival, it has raised concerns about disadvantaging minority groups, particularly black patients, and pediatric patients, who have severe growth retardation and other problems when dialysis is prolonged before transplantation," the authors write as background information in the article. "Currently, only HLA-DR matching is considered in the United Network for Organ Sharing (UNOS) organ allocation system."
To examine the relationship between HLA-DR mismatching and rejection, graft survival and sensitization in pediatric kidney transplant patients, Lan T. Vu, M.D., and colleagues from the University of California at San Francisco, conducted a retrospective cohort study of 178 pediatric patients who underwent primary kidney transplantation with daclizumab induction therapy (to prevent organ rejection) at the University of California, San Francisco between 1997 and 2006.
One year after transplantation, 35 percent of the patients experienced rejection and at five year follow-up the frequency of rejection was 55 percent. Patients with 1- or 2-HLA-DRB1 mismatches had 1.7 times greater odds of rejection than patients with no HLA-DRB1 mismatches. "This single-center study demonstrated that HLA-DRB1 mismatching increased the risk of allograft rejection by approximately 70 percent in children," write the authors.
Additionally, the 1- and 5-year graft survival rates for this study group were 97 percent and 82 percent respectively, and the authors found that the degree of HLA-DRB1 mismatches were not significantly related to graft failure. However, patients with a history of rejection had 7.7 times greater odds of graft failure than those who had not previously had an episode of rejection.
"In conclusion, this study showed that HLA-DRB1 mismatch was a risk factor for rejection and that rejection was a strong predictor of graft failure and sensitization in children," the authors write. "Based on the high incidence of rejection and sensitization seen with HLA-DR–mismatched kidneys observed in this series, we advocate expansion of the current artificial boundaries of donor pools to facilitate better matching and outcomes for young recipients."
###
(Arch Surg. 2011;146[7]:824-829. Available pre-embargo to the media at www.jamamedia.org.)
Editor's Note: Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.
To contact corresponding author Peter G. Stock, M.D., Ph.D., call Juliana Bunim at 415-502-NEWS or e-mail Juliana.Bunim@ucsf.edu.
END
ELSE PRESS RELEASES FROM THIS DATE:
2011-07-19
The rate of adverse events and harm reported at Veterans Health Administration (VHA) medical centers appears to have decreased, according to a report published Online First by Archives of Surgery, one of the JAMA/Archives journals.
According to background information in the article, reports of wrong-site surgery range from 0.09 to 4.5 per 10,000 cases. "This 50-fold range in the estimated incidence reflects the variety of results reported in various settings and different methods for defining adverse events in this area," explain the authors. Their article represents ...
2011-07-19
Dunwoody Wellness Center plans to offer Atlanta residents holistic rejuvenation treatments for the skin and body, as it celebrates its official grand opening on International Wellness Day on July 18, 2011.
The First Annual International Wellness Day was held on July 19, 2010, in conjunction with the National Wellness Conference in Stevens Point, Wisconsin. Countries represented included Brazil, Argentina, US, Canada, Great Britain, Germany, Austria, South Africa, Australia, China, and Japan. While Dunwoody Wellness may not be sending a representative to this year's event, ...
2011-07-19
Exposure to secondhand smoke (SHS) is associated with increased risk of hearing loss among adolescents, according to a report in the July issue of Archives of Otolaryngology–Head and Neck Surgery, one of the JAMA/Archives journals.
Among U.S. children, approximately 60 percent are exposed to SHS, according to background information in the article. Studies have associated exposure to secondhand smoke prenatally or during childhood with various health conditions, from low birth weight and respiratory infections to behavioral problems and otitis media. Children exposed to ...
2011-07-19
Mathematical modeling of infectious diseases is an important tool in the understanding and prediction of epidemics. Knowledge of social interactions is used to understand how infectious diseases spread through populations and how to control epidemics. New research published in BMC Medicine shows that a model, which included dynamic information about the heterogeneity of contact length and rate of making new contacts, was as effective as a more complex model which included the order of contacts.
Data was collected over a two-day period, within the Socio Patterns project, ...
2011-07-19
When the Hamiltons purchased their holiday home in Camposol Golf on the Costa Cálida six years ago, they had no aspirations for amassing a property portfolio. However, a combination of Barry's upcoming retirement and news of a Paramount-branded Theme Park encouraged them to take advantage of the current buyers' market and purchase an additional home in Camposol Golf.
Barry (51), from County Antrim in Northern Ireland, picks up the story, "Spain was an obvious choice for us as it's just a couple of hours by direct flight from Belfast, has excellent infrastructure, ...
2011-07-19
Taking another major step in sleuthing the 2010 Deepwater Horizon oil spill, a research team led by the Woods Hole Oceanographic Institution (WHOI) has determined what chemicals were contained in a deep, hydrocarbon-containing plume at least 22 miles long that WHOI scientists mapped and sampled last summer in the Gulf of Mexico, a residue of the Deepwater Horizon oil spill. Moreover, they have taken a big step in explaining why some chemicals, but not others, made their way into the plume.
The findings, published this week in the online edition of the Proceedings of the ...
2011-07-19
CHICAGO – Among Latinos living in the United States, acculturation is associated with sunscreen use, but not with use of sun-protective clothing, according to a report in the July issue of Archives of Dermatology, one of the JAMA/Archives journals.
According to background information in the article, DNA damage and skin cancer are an important health issue for U.S. Latinos. Their annual age-adjusted incidence of melanoma is 4.5 per 100,000, which represents an increase of 28.6 percent since 1992. Further, when melanoma is diagnosed, it tends to be thicker among Latinos ...
2011-07-19
Young Frankenmuth writer Christopher Mundie has written a funny, up-beat book about the life of a special kind of guy; the kind of guy you wouldn't want to have at your party or end up owing any favors to. You know the type, the cynical, sarcastic, self-centered, lying and conniving—he's The Jerk. Being a Jerk isn't so bad though, it can get you free coffee, wads of cash and a gigantic fish (if you're lucky). You can definitely hate him, but there's one thing you can't blame him for, and that's for bumping into him in the first place.
I spoke with Christopher Mundie ...
2011-07-19
Physician-based screening for melanoma is associated with higher rates of physician-detected melanoma and detection of thinner melanoma, according to a report published Online First today by Archives of Dermatology, one of the JAMA/Archives journals.
The disease-specific survival rate for advanced-stage melanoma is poor, so detecting the cancer in an earlier stage is the best means to ensure a favorable prognosis, according to background information in the article. Previous research has demonstrated that patients find most melanomas, and that those lesions tend to be ...
2011-07-19
Removing a portion of the platysma muscle may ease symptoms for patients experiencing chronic neck stiffness and involuntary movement, according to a report in the July issue of Archives of Facial Plastic Surgery, one of the JAMA/Archives journals.
In previous research, removal of parts of the platysma—the muscle stretching from the shoulders and chest through the neck—appeared successful in alleviating hypertonicity (muscular rigidity), according to background information in the article. The authors, who had begun to use muscle-transfer surgeries to treat facial paresis ...
LAST 30 PRESS RELEASES:
[Press-News.org] Study examines factors in pediatric kidney transplant rejection
