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Accommodation in ABO-incompatible Kidney Transplantation

9780444517456
657,00 zł
591,00 zł Zniżka 66,00 zł Brutto
Najniższa cena w okresie 30 dni przed promocją: 591,00 zł
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Opis
For most people today, ABO-incompatible kidney transplantation still carries the image of pronounced hyperacute rejection. However, with modern immunosuppressive therapy, hyperacute rejection will not occur within the first 24 hours. Clinical statistics in Japan show 3 cases of hyperacute rejection, but all of these occurred because the recipient was mistakenly transfused during surgery with frozen plasma of the same blood type. Delayed hyperacute rejection, occurring after the first 24 hours, is most likely to develop within 1 week post transplant. It does not manifest suddenly, but several years after transplantation. This means that humoral rejection ceases to occur after accommodation has been established. The use of evidence-based medicine to correct misconceptions in this area has proven to be meaningful.

The publication of these data has made it possible to break down fixed thinking and prejudices previously regarded as fact in relation to ABO-incompatible kidney transplantation. It is believed that this will prove to be a major contribution in the future development of immunology. As these data are provided as a common resource for physicians performing transplantation procedures, it has encouraged more widespread implementation of organ transplantation.
Szczegóły produktu
Churchill Livingstone
47657
9780444517456
9780444517456

Opis

Rok wydania
2004
Numer wydania
1
Oprawa
twarda
Liczba stron
230
Waga (g)
590
  • Preface. Personal History. 1. History. Acknowledgements. References. 2. Current status of treatment for chronic renal failure and factors behind increasing use of ABO-incompatible kidney transplantation in Japan. Acknowledgements. References. 3. Indications and considerations. 3.1 Indications. 3.2 Crossmatch test. 3.3 Anti-A/anti-B (anti-A, anti-B, and anti-AB) antibodies. 3.4 Age and dialysis history. 3.5 Infection/ 3.6 Anticoagulation therapy. 3.7 Informed consent. Acknowledgements. References. 4. Blood group antigens, histo-blood group antigens, and their antibodies. 4.1 Differences between blood group antigens and histo-blood group antigens. 4.2 ABO(H) blood group gene, blood group glycosyltransferase (a gene product), and blood group antigens. 4.3 Distribution of ABO blood group antigens throughout the body and within the kidneys 4.4 Measuring anti-A and -B antibodies. 4.5 Origin of ABO blood group glycosyltransferase. 4.6 ABO blood group antigens and other blood group antigens. 4.7 Lymphocyte crossmatch test and vascular endothelial cell crossmatch test. 4.8 The role of ABO blood group antigens and HLA antigens in bone marrow transplants and organ transplants. Acknowledgements. References. 5. Rejection. 5.1 Considerations regarding rejection mechanism. 5.2 Mechanism and classification of rejection in ABO-incompatible kidney transplantation. Acknowledgements. References. 6. Accommodation in ABO-incompatible kidney transplantation - why do kidney grafts survive. 6.1 Carbohydrate blood group substances and ABO blood group antigens on erythrocytes. 6.2 ABO(H) blood group gene, blood group glycosyltransferase (products of these genes), and blood group antigens. 6.3 Formation of ABO glycosyltransferase. 6.4 Inhibitors and antibodies to ABO glycosyltransferase, and antibodies to ABO blood group antigens. 6.5 The role of ABO blood group antigens and the HLA antigen system in bone marrow transplantation and organ transplantation. 6.6 Organ transplantation and ischemic time. 6.7 Definition of the terms hyperacute rejection and delayed hyperacute rejection and their times of onset. 6.8 Why do kidney grafts survive The answer is accommodation. 6.9 Classification of humoral rejection (antibody-mediated rejection) by time period in ABO-incompatible kidney transplantation. 6.10 Classification of humoral rejection in ABO-incompatible kidney transplantation. Acknowledgements. References. 7. Immunosuppressive therapy. 7.1 Considerations for immunosuppressive therapy in kidney transplantation. 7.2 Induction period immunosuppressive therapy in ABO-incompatible kidney transplantation. 7.3 Immunosuppressive therapy for maintenance period. 7.4 Treatment for rejection. 7.5 Effects and complications of splenectomies. Acknowledgements. References. 8. New strategy for immunosuppression. 8.1 New ways of thinking about immunosuppressive therapy in ABO-incompatible kidney transplantation. 8.2 Establishing accommodation. 8.3 Preventing delayed hyperacute rejection (accelerated acute antibody-mediated rejection). Acknowledgements. References. 9. Surgical procedures. 9.1 Introduction. 9.2 Kidney transplantation. 9.3 Splenectomies. 9.4 Other surgical procedures. 9.5 Donor nephrectomy. Acknowledgements. References. 10. Prevention and treatment of infections. 10.1 Basic considerations for posttransplant infections. 10.2 Prevention and treatment for cytomegalovirus infection. 10.3 Vaccination. Acknowledgements. References. 11. Current status of ABO-incompatible kidney transplantation in Japan, 2002. 11.1 Introduction. 11.2 Objectives, target population, and methodology of the survey. 11.3 Current status of ABO-incompatible kidney transplantation in Japan. 11.4 Follow-up survey and statistical analysis of patients undergoing ABO-incompatible kidney transplantations. 11.5 Results. 11.6 Discussion. 11.7 Summary. 11.8 Conclusion. Acknowledgements. References. 12. Case studies. 12.1 Introduction. 12.2 Stage 1 immunosuppressive therapy (January 1989 to March 1996). 12.3 Stage 2 immunosuppressive therapy (April 1996 to February 1999). 12.4 Stage 3 immunosuppressive therapy (March 1999 to December 1999). 12.5 Stage 4 immunosuppressive therapy (January 2000 to March 2002). 12.6 Stage 5 immunosuppressive therapy (April 2002 to present). Acknowledgements. References. 13. If graft loss occurs 13.1 When graft loss occurs as a result of delayed hyperacute rejection (accelerated acute AMR). 13.2 Graftectomy. Acknowledgements. References. 14. Candid advice from a transplant specialist. 14.1 Dissociation of the studies of basic immunology and clinical immunology. 14.2 Necessity of immunological tolerance. 14.3 Necessity of pharmacological immunosuppressive therapy. References. 15. Findings regarding ABO-incompatible transplantation and future tasks. 15.1 Background (Chapter 2). 15.2 Indications (Chapter 3). 15.3 Results in Japan (Chapter 11). 15.4 Checking for crossmatching (Chapter 4). 15.5 Rejection (Chapters 5-8). 15.6 Anti-a/Anti-b antibodies (Chapters 4 and 8). 15.7 Mechanism (hypothetical) of the establishment of accommodation (Chapters 6 and 8). 15.8 Immunosuppressive therapy (Chapters 6-8 and 11). 15.9 Surgical techniques and perioperative management (Chapter 9). 15.10 Prevention of posttransplant infection. References. Closing Remarks. Abbreviations. Subject Index.
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