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Results: 31 to 33 of 33

Publication Record


Renal replacement therapies in the elderly: Part II. Renal transplantation.
Ismail N, Hakim RM, Helderman JH
(1994) Am J Kidney Dis 23: 1-15
MeSH Terms: Aged, Cadaver, Graft Survival, Humans, Immunosuppression, Kidney Failure, Chronic, Kidney Transplantation, Renal Dialysis, Survival Analysis
Show Abstract · Added May 20, 2014
The United States end-stage renal disease (ESRD) population is growing progressively older. As a percentage of the overall ESRD population, the number of patients 65 years of age and older approached 40% by 1989. However, the percentage of ESRD patients with a functioning transplant was only 2.7% in this age group. Success of transplantation in geriatric ESRD patients over the last decade is due to improved patient selection as well as the use of cyclosporine A and lower doses of corticosteroids, with the achievement of 1-year patient and graft survival rates of 85% and 75%, respectively. For patients older than 60 or 65 years, the 5-year "functional" graft survival is 55% to 60%. Although overall results are excellent, the management of transplantation in the elderly requires an understanding of pharmacology, immunology, and physiology peculiar to this age group. Since the elderly have a degree of immune incompetence, they require less aggressive immunotherapy. Elderly patients have decreased hepatic enzyme activity, especially the P450 system, and therefore require a lower cyclosporine dose. Although elderly patients experience less rejection episodes than younger patients, graft loss in the elderly transplant recipient is due mainly to patient death. Most common causes of death in the elderly transplant recipient are cardiovascular disease and infection related to peaks of immunosuppression. Shortage of cadaver kidneys and limited life expectancy of the geriatric ESRD patient make allocation of cadaver kidneys to patients over 70 years (and even 65 years) a controversial issue and an ethical dilemma. Use of elderly cadaver donors (over 55 to 60 years) is associated with inferior success rates and is not an optimal solution to shortage of cadaver kidneys.
0 Communities
1 Members
0 Resources
9 MeSH Terms
Selected complications of allogeneic bone marrow transplantation.
Wujcik D, Ballard B, Camp-Sorrell D
(1994) Semin Oncol Nurs 10: 28-41
MeSH Terms: Acute Kidney Injury, Bacterial Infections, Bone Marrow Transplantation, Graft vs Host Disease, Hepatic Veno-Occlusive Disease, Humans, Immunosuppression, Risk Factors
Show Abstract · Added March 27, 2014
Patients receiving allogeneic bone marrow transplant experience multiple complications. Specifically, infection, renal complications, VOD, and GVHD can produce life-threatening toxicity. Many of the treatments cause further compromise of major organs. Astute nursing assessment and prompt interventions can decrease the severity experienced by the patient. Each of these complications requires ongoing study to develop new therapies for management.
0 Communities
1 Members
0 Resources
8 MeSH Terms
Modification of diverse experimental immunosuppressive states by glucan.
Di Luzio NR, Williams DL, Sherwood ER, Browder IW
(1985) Surv Immunol Res 4: 160-7
MeSH Terms: Alcoholism, Animals, Bacterial Infections, Bone Marrow Transplantation, Glucans, Humans, Immune Tolerance, Immunosuppression, Immunotherapy, Leukemia, Experimental, Mice, Radiation Chimera, Splenectomy, Surgical Wound Infection, Transplantation, Homologous
Added October 18, 2015
0 Communities
1 Members
0 Resources
15 MeSH Terms