Renal transplantation is the treatment of choice for patientswith end-stage renal disease. Better comprehension of the rejectionresponse, improved preservation of organs, judicious use ofcyclosporine, the application of antilymphocyte agents for theprevention and treatment of rejection, and specific protocolsfor the prevention and treatment of infection have all contributedto the recent improvement in outcome after renal transplantation.
Immunobiology of Renal Transplantation
The Anti-Allograft (Rejection) Response
Renal-allograft rejection depends on the coordinated activationof alloreactive T cells and antigen-presenting cells (e.g.,monocyte-macrophages, dendritic cells, and B cells). Whereasacute rejection is a T-cell-dependent process, a broad arrayof effector mechanisms participate in the destruction of . . . [Full Text of this Article]
Antigenic Stimulation
Costimulatory Signals
Interleukin-2-Stimulated T-Cell Proliferation
Immunopharmacology of Allograft Rejection
Cyclosporine and Tacrolimus
Corticosteroids
Azathioprine
New Drugs
Clinical Aspects
Current Status
Organ Shortage
Characteristics of Kidney Donors and Recipients
Causes of End-Stage Renal Disease Managed by Renal Transplantation
The Surgical Procedure and Its Complications
Costs
Factors Affecting Transplantation Outcomes
HLA Matching
Cross-Matches
Immunosuppressive Regimens
Adjunctive Vasodilation Therapy
Prophylaxis against Infection
Pregnancy
Chronic Rejection
Hypertension
Dyslipidemia
Recurrence of Disease
Liver Disease
Cancer
Osteopenia
Conclusions
Source Information
From the Rogosin Institute, Department of Medicine, New York Hospital-Cornell Medical Center, New York (M.S.); and the Department of Medicine, Harvard Medical School, and Beth Israel Hospital, Boston (T.B.S.).
Address reprint requests to Dr. Strom at the Department of Medicine, Division of Immunology, Beth Israel Hospital, 330 Brookline Ave., Boston, MA 02215.
References
Related Letters:
Renal Transplantation
King P. D., Lidor C., Vail T. P., Suthanthiran M., Strom T. B.
Extract |
Full Text
N Engl J Med 1994;
331:1719-1720, Dec 22, 1994.
Correspondence
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