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Related Concept Videos

Kidney Transplant I: Introduction01:28

Kidney Transplant I: Introduction

A kidney transplant is a surgical approach that involves replacing a non-functioning kidney with a healthy one from a donor. This procedure is often a treatment option for end-stage renal disease (ESRD) patients. The method requires careful recipient selection, including evaluating various medical and psychosocial factors. These criteria vary between transplant centers but generally include assessments of the patient's overall health, adherence to medical recommendations, and lifestyle...
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Kidney Transplant II: Surgical Procedure

Preoperative ManagementThe primary goals of preoperative management in kidney transplantation are to optimize the patient’s metabolic state and prepare them for surgery through diet adjustments, necessary dialysis, and tailored medical treatment. This phase also involves comprehensive infection screening and patient education about the surgical procedure and postoperative care to improve outcomes and adherence.Medical ManagementA comprehensive evaluation is required for both the living donor...
Tissue Transplantation01:24

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Tissue transplantation is a significant medical procedure involving the transfer of cells, tissues, or organs from a donor to a recipient, with the primary aim of restoring lost functions. This procedure is crucial in treating a broad spectrum of diseases, including kidney diseases, liver failure, heart disease, and certain types of cancers.
The Biology of Tissue Transplantation
The biology of tissue transplantation hinges on the Major Histocompatibility Complex (MHC) molecules. These molecules...
Kidney Transplant III: Nursing Management01:16

Kidney Transplant III: Nursing Management

Postoperative Nursing Management for Kidney Transplant PatientsPostoperative nursing management care includes monitoring the surgical site, encouraging early movement, and promoting lung health through breathing exercises. Nurses also administer prescribed medications like H2-blockers, such as famotidine, or proton pump inhibitors, like omeprazole, to help prevent gastrointestinal ulcers and bleeding. Fungal infections in the mouth and bladder can result from immunosuppressive and antibiotic...
Acute Kidney Injury III: Clinical Manifestations01:29

Acute Kidney Injury III: Clinical Manifestations

Acute Kidney Injury (AKI) progresses through distinct clinical phases: the oliguric, diuretic, and recovery phases, each marked by unique manifestations and challenges.Oliguric Phase:The oliguric phase is the initial stage of AKI, typically lasting 10 to 14 days. This phase is marked by a significant reduction in urine output, usually less than 400 mL per day, indicating decreased kidney function. Fluid retention is a prominent feature, leading to symptoms such as edema, hypertension, and...
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Personalized Peptide Arrays for Detection of HLA Alloantibodies in Organ Transplantation
08:07

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Published on: September 6, 2017

HLA-A amino acid polymorphism and delayed kidney allograft function.

Malek Kamoun1, John H Holmes, Ajay K Israni

  • 1Department of Pathology and Laboratory Medicine, University of Pennsylvania School of Medicine, Philadelphia, PA 19104, USA. malekkam@mail.med.upenn.edu

Proceedings of the National Academy of Sciences of the United States of America
|November 27, 2008
PubMed
Summary

Amino acid mismatches in HLA-A molecules significantly impact delayed allograft function (DGF) after kidney transplants. Specific mismatches at crucial sites increase DGF risk, while others may decrease it, offering insights into transplant outcomes.

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Trans-vivo Delayed Type Hypersensitivity Assay for Antigen Specific Regulation

Published on: May 2, 2013

Area of Science:

  • Immunogenetics
  • Transplantation immunology
  • Molecular biology

Background:

  • Delayed allograft function (DGF) is a frequent complication following kidney transplantation.
  • Both nonimmunologic factors (e.g., donor age, ischemia time) and immunologic factors contribute to DGF.
  • Understanding the immunologic basis of DGF is crucial for improving transplant success rates.

Purpose of the Study:

  • To investigate the association between amino acid mismatches at specific HLA-A molecule sites and the occurrence of DGF in renal transplant recipients.
  • To identify critical HLA-A amino acid positions that influence DGF risk.
  • To explore the role of HLA-A polymorphism and evolutionary features in DGF development.

Main Methods:

  • Prospective cohort study of 697 renal transplant recipients from deceased donors.
  • Analysis of amino acid mismatches at 66 variable sites of the HLA-A molecule.
  • Multivariate logistic regression adjusted for nonimmunologic risk factors.

Main Results:

  • Combinations of amino acid mismatches at crucial HLA-A sites were associated with DGF.
  • Mismatches at functionally important antigen recognition sites (positions 62, 95, 163) increased DGF risk in Caucasian recipients.
  • Mismatches at HLA-A family-specific sites (149, 184, 193, 246) were associated with a decreased risk for DGF.

Conclusions:

  • Amino acid polymorphisms at functionally important HLA-A positions significantly influence DGF.
  • HLA-A antigen recognition site polymorphisms are key determinants of DGF risk.
  • Evolutionary features of HLA-A polymorphism may modulate alloreactivity and impact DGF.