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排序方式: 共有156条查询结果,搜索用时 15 毫秒
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Detection of HLA class I and II antibodies by ELISA and complement-dependent cytotoxicity before and after transplantation 总被引:2,自引:0,他引:2
BACKGROUND: Anti-class I IgG can be detected by complement-dependent cytotoxicity (CDC) and by ELISA. We compared ELISA and CDC for both class I and class II antibodies on method agreement and relation to rejection-free and graft survival. METHODS: Peak, current, and posttransplant sera (n=429) of 143 renal allograft patients were tested by National Institutes of Health technique (NIHT), two-color fluorescence (TCF), and ELISA. Method agreement was assessed by intraclass correlation coefficient (ICC). Rejection and graft survival were analyzed by uni- and multivariate techniques. The screening results for each serum were compared, as was the change in result of current to posttransplant serum. RESULTS: The ICC of ELISA and NIHT was insufficient; it was lower for TCF than NIHT. Graft survival was not related to the result of any assay. Rejection-free survival was related to ELISA and NIHT in current and posttransplant serum. With the NIHT, the change in percent panel-reactive antibody (%PRA) correlated better with rejection than it did with ELISA. The combined antibody status of current and posttransplant serum was a risk factor for rejection in all assays, and for TCF also in multivariate analysis. The rejection rate was higher if the posttransplant serum was ELISA-negative/CDC-positive, rather than ELISA-positive/CDC-negative. For ELISA, class I specificities (and not %PRA) in peak and current sera were related to rejection, even if the antibodies were not donor-directed. In the case of the National Institutes of Health technique (NIHT), %PRA and not specificity was related to rejection. Class II antibodies were never related to rejection. CONCLUSIONS: ELISA and NEIT are complementary screening techniques in this patient population. They are of equal predictive value for rejection. The optimal strategy in combining these techniques must be determined. 相似文献
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MR renography: an algorithm for calculation and correction of cortical volume averaging in medullary renographs 总被引:1,自引:0,他引:1
de Priester JA den Boer JA Giele EL Christiaans MH Kessels A Hasman A van Engelshoven JM 《Journal of magnetic resonance imaging : JMRI》2000,12(3):453-459
We evaluated a mathematical algorithm for the generation of medullary signal from raw dynamic magnetic resonance (MR) data. Five healthy volunteers were studied. MR examination consisted of a run of 100 T1-weighted coronal scans (gradient echo; TR/TE 11/3.4 msec, flip angle 60 degrees; slice thickness 6 mm; temporal resolution 2 seconds). Gadolinium-diethylene triamine pentaacetic acid (DTPA; 0. 05 mmol/kg) was injected with an injector pump (5 ml/sec). Medullary MR renographs (MRRs) were calculated for regions of interest with strong and moderate cortical volume averaging (CVA). A reference medullary MRR, devoid of CVA, was obtained. Percentual signal differences between calculated and reference medullary MRRs were estimated for each consecutive scan. Run averaged values of these differences were calculated. Mean values, after subtraction of the resting state signal, were +0.2% (SD 9.7%) and +0.7% (SD 9.0%) for areas with strong and moderate CVA, respectively. We conclude that with this algorithm reliable extraction of medullary MRRs is feasible, providing a unique tool for clinical evaluation of medullary disease. J. Magn. Reson. Imaging 2000;12:453-459. 相似文献
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Oleg Rummo Mario Carmellini Nassim Kamar Antoine Durrbach Christiane Mousson Flavia Caputo Zoltan Mathe Maarten H. L. Christiaans Dirk R. J. Kuypers Jürgen Klempnauer Swapneel Anaokar Martin Hurst Gbenga Kazeem Nasrullah Undre Frank Lehner 《Transplant international》2020,33(2):161-173
The objectives of this study were to assess long-term graft survival, patient survival, renal function, and acute rejections in de novo kidney transplant recipients, treated with once-daily prolonged-release tacrolimus-based therapy. The study was a 5-year non-interventional prospective follow-up of patients from the ADHERE study, a Phase IV 12-month open-label assessment of patients randomized to receive prolonged-release tacrolimus in combination with mycophenolate mofetil (MMF) (Arm 1) or sirolimus (Arm 2). From 838 patients in the randomized study, 587 were included in the long-term follow-up, of whom 510 completed the study at year 5. At 1 year post-transplant, graft and patient survival rates were 93.0% and 97.8%, respectively, and at 5 years were 84.0% and 90.8%, respectively. Cox proportional hazards analysis showed no association between graft loss, initial randomized treatment arm, donor age, donor type, or sex. The 5-year acute rejection-free survival rate was 77.4%, and biopsy-confirmed acute rejection-free survival rate was 86.0%. Renal function remained stable over the follow-up period: mean ± SD eGFR 4-variable modification diet in renal disease formula (MDRD4) was 52.3 ± 21.6 ml/min/1.73 m2 at 6 months and 52.5 ± 23.0 ml/min/1.73 m2 at 5 years post-transplant. These findings support the role of long-term once-daily prolonged-release tacrolimus-based immunosuppression, in combination with sirolimus or MMF, for renal transplant recipients in routine clinical practice. 相似文献
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G. Franschman S.M. Peerdeman S. Greuters J. Vieveen A.C.M. Brinkman H.M.T. Christiaans E.J. Toor G.N. Jukema S.A. Loer C. Boer 《Resuscitation》2009,80(10):1147-1151
The international Brain Trauma Foundation guidelines recommend prehospital endotracheal intubation in all patients with traumatic brain injury (TBI) and a Glasgow Coma Scale (GCS) ≤ 8. Close adherence to these guidelines is associated with improved outcome, but not all severely injured TBI patients receive adequate prehospital airway support. Here we hypothesized that guideline adherence varies when skills are involved that rely on training and expertise, such as endotracheal intubation.We retrospectively studied the medical records of CT-confirmed TBI patients with a GCS ≤ 8 who were referred to a level 1 trauma centre in Amsterdam (n = 127). Records were analyzed for demographic parameters, prehospital treatment modalities, involvement of an emergency medical service (EMS) and respiratory and metabolic parameters upon arrival at the hospital.Patients were mostly male, aged 45 ± 21 years with a median injury severity score (ISS) of 26. Of all patients for whom guidelines recommend endotracheal intubation, only 56% were intubated. In 21 out of 106 severe cases an EMS was not called for, suggesting low guideline adherence. Especially those TBI patients treated by paramedics tended to develop higher levels of stress markers like glucose and lactate.We observed a low degree of adherence to intubation guidelines in a Dutch urban area. Main reasons for low adherence were the unavailability of specialized care, scoop and run strategies and absence of a specialist physician in cases where intubation was recommended. The discrepancy between guidelines and reality warrants changing practice to improve guideline compliance and optimize outcome in TBI patients. 相似文献
7.
Trough levels of tacrolimus 总被引:1,自引:0,他引:1
Stolk LM Van Duijnhoven EM Christiaans MH van Hooff JP 《Therapeutic drug monitoring》2002,24(4):573; author reply 573-573; author reply 574
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ter Meulen CG Hilbrands LB van Riemsdijk-van Overbeeke IC Hené RJ Christiaans MH Hoitsma AJ 《Nederlands tijdschrift voor geneeskunde》2000,144(50):2396-2400
Four major double-blind randomized trials in kidney transplant patients have shown that the interleukin-2 receptor (IL-2R alpha) antagonists declizumab or basiliximab, when added to an immunosuppressive regimen consisting of cyclosporin and prednisone, reduce the incidence of acute rejections after kidney transplantation by 30-40%, during the first 6 months. Daclizumab and basiliximab are monoclonal antibodies of which the variable parts are of mouse origin and the other components of human origin. The addition of the interleukin-2 receptor antagonists was not accompanied by extra side effects. Ongoing clinical trials aim at answering the question whether the addition of daclizumab and basiliximab will allow to avoid or decrease the use of more toxic immunosuppressive drugs. 相似文献
10.
ter Meulen CG van Riemsdijk I Hené RJ Christiaans MH Borm GF Corstens FH van Gelder T Hilbrands LB Weimar W Hoitsma AJ 《Transplantation》2004,78(1):101-106
BACKGROUND: Steroid-related bone loss is a recognized complication after renal transplantation. In a prospective, randomized, multicenter study we compared the influence of a steroid-free immunosuppressive regimen with a regimen with limited steroid exposure on the changes in bone mass after renal transplantation. METHODS: A total of 364 recipients of a renal transplant were randomized to receive either daclizumab (1 mg/kg on days 0 and 10 after transplantation; steroid-free group n=186) or prednisone (0.3 mg/kg per day tapered to 0 mg at week 16 after transplantation; steroids group n=178). All patients received tacrolimus, mycophenolate mofetil, and, during the first 3 days, 100 mg prednisolone intravenously. Changes in bone mineral density (BMD) were evaluated in 135 and 126 patients in the steroid-free and steroids group, respectively. RESULTS: The mean (+/- SD) BMD of the lumbar spine decreased slightly in both groups during the first 3 months after transplantation (steroid-free -1.3 +/- 4.0% [P<0.01]; steroids -2.3 +/-4.2% [P<0.01]). In the following months, lumbar BMD recovered in both groups (P<0.01), resulting in a lumbar BMD at 12 months after transplantation comparable with the baseline value. No difference between the groups was found at 3 months (steroid-free versus steroids +1.0%; 95% confidence interval -0.0%-+2.0%, P=0.060) and at 12 months after transplantation (steroid-free versus steroids +0.9%; 95% confidence interval -0.8%-+2.6%, NS). CONCLUSION: The use of a moderate dose of steroids during 4 months after transplantation has no important influence on bone mass during the first year after renal transplantation. On average, both regimens prevented accelerated bone loss. 相似文献