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Title
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Fibrous intimal thickening at implantation adversely affects long-term kidney allograft function
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Author
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Abstract
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| Background. Kidneys from marginal and older donors are increasingly used to respond to the increasing demand for kidney transplants. This study evaluated the predictive value of intimal hyperplasia, as a marker of vasculopathy, in the renal allograft at the time of transplantation (transplantation) on the subsequent graft function (7 years). Methods. The intima/media ratio of the arterial walls (I/M) was morphometrically determined by the sectorial elliptic method, in 51 implantation biopsies. Two study groups were determined. Group 1, with I/M less than or equal to 0.47, was considered as the group with minimal vascular damage at transplantation. Group 2, with I/M more than 0.47, was considered as having vasculopathy at transplantation. Results. During the first 15 months, the estimated glomerular filtration rate improved in group 1 from 53+/-17 to 61+/-17 mL/min/1.73 m2, whereas it decreased from 51+/-21 to 46+/-14 mL/min/1.73 m2 in group 2. From 1 year posttransplantation, the estimated glomerular filtration rate (eGFR) was significantly higher in group 1 at all time points (6 month evaluation). The difference in graft function between the two groups (mean, 11 mL/min/1.73 m2) remained unchanged between 1 and 7 years posttransplantation. Among several clinical parameters investigated, blood pressure of the recipient significantly modulates the impact of preexisting vasculopathy on graft function. Conclusion. Our data provide evidence that donor-related vasculopathy, at the time of transplantation, has a persistent significant impact on the subsequent graft function. This effect becomes only apparent at 1 year posttransplantation and is increased in recipients with inadequately controlled blood pressure. |
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Language
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English
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Source (journal)
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Transplantation. - Baltimore, Md, 1963, currens
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Publication
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Baltimore, Md
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2009
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ISSN
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0041-1337
1534-6080
[online]
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DOI
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10.1097/TP.0B013E31818BBE06
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Volume/pages
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87
:1
(2009)
, p. 72-78
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ISI
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000262483700012
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Full text (Publisher's DOI)
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