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Biomedical subjects

G G Persijn

Publications and source records attributed to G G Persijn.

At least 109 records · Page 6Linked to original sources
PubMed1988

The interaction between the Lewis blood group system and HLA-matching in renal transplantation.

A retrospective study was initiated to investigate the influence of recipients' Lewis subtype and HLA-matching on cadaveric kidney graft outcome. A total of 1111 patients receiving a first cadaveric kidney graft were analyzed. No difference in one-year graft survival was found between Lewis-negative (73%, n = 133) and Lewis-positive (73%, n = 978) recipients. Further subdivision of the study group into HLA-A,-B well-matched (0 or 1 mismatches [MM]) and poorly matched (2, 3, or 4 MM) revealed a strong deleterious effect of HLA-A,-B mismatching in the Lewis-negative group only. One year graft survival in Lewis-negative HLA-A,-B poorly matched (2, 3, or 4 A,B MM) patients was 60% (n = 67) versus 86% (n = 66) in the Lewis-negative HLA-A,-B well-matched (0 or 1 A,B MM) group (P = 0.004). For the Lewis-positive group the one-year graft survival rates were 72% (2, 3, or 4 A,B MM; n = 498) and 74% (0 or 1 A,B MM; n = 480), respectively (P = n.s.). The additional beneficial effect of HLA-DR matching again turned out to be strongest in the Lewis-negative group. In Lewis-negative, HLA-DR (0 MM) and -A,-B well-matched recipients (n = 36) graft survival was 94% versus only 64% in the Lewis-negative, DR matched, A,-B mismatched (2, 3, or 4 A,B MM) group (n = 25; P = 0.09). In the Lewis-positive, HLA-DR 0 mismatched group the one-year survival rates were 78% (0 or 1 A,B MM; n = 240) and 73% (2, 3, or 4 A,B MM; n = 253), respectively (P = 0.05). Our data suggest that donor recipient selection should not be based on Lewis matching per se. However, since Lewis-negative patients are at high risk of graft failure when receiving HLA mismatched kidneys, they should preferentially receive optimally HLA matched grafts.

ABO Blood-Group System↗
PubMed1988

Time trend in annual kidney graft survival.

First cadaver, unrelated kidney graft survival at one year from 50 Eurotransplant centers was analyzed and found to show marked changes in survival rates over the 20-year period from 1967 to 1986 inclusive. Full information on HLA-A, -B, and -DR matching and use of cyclosporine therapy was only available for the period 1981 to 1986. When these factors were allowed for, the number (and type) of HLA mismatches was shown to have a significant and independent effect on differences in survival rates whereas the effect of cyclosporine differed over the different years.

Cadaver↗
PubMed1988

The effect of mismatching and sharing of HLA-A, -B, and -DR antigens on kidney graft survival in Eurotransplant 1982 to 1988.

1. Cyclosporine significantly improved kidney graft survival by 10-15%. 2. Matching for HLA-DR, HLA-B + DR and HLA-A + B + DR improved kidney graft survival significantly in non-CsA-treated patients. 3. Matching for the HLA-A, -B, and -DR loci, apart and in combination, significantly improved kidney graft survival in CsA-treated patients. 4. The best kidney graft survival was observed in HLA-A + B + DR identical combinations treated with CsA (76% at 5 yrs).

Cyclosporins↗
PubMed1987

Evidence that the difference in kidney graft survival in DRw6+ and DRw6- recipients may be explained by a blood transfusion policy that is disadvantageous for DRw6+ recipients.

Kidneys transplanted to HLA-DRw6+ recipients have been shown to have an inferior graft survival compared with DRw6- patients. Because pretransplant blood transfusions influence kidney graft survival, we investigated whether the number of blood transfusions contributes to the observed poor graft survival in DRw6+ patients. We have found that the difference in graft survival in DRw6+ and DRw6- recipients may be explained by a blood transfusion policy that is disadvantageous for DRw6+ recipients. Thus, graft survival in DRw6+ recipients was excellent for those who had received only a single transfusion. More transfusions resulted in a gradual decrease in graft survival. When the number of transfusions exceeded 5, graft survival improved again. By contrast, DRw6- recipients showed an improvement in graft survival with an increasing number of transfusions. DRw6+ recipients therefore display inferior graft survival only when they receive 3-5 transfusions. This finding provides a possible explanation as to why the "DRw6 effect" is a controversial issue, and it suggests that DRw6+ recipients should be given a different pre-transplant transfusion protocol than DRw6- patients.

Cyclosporins↗
PubMed1987

Factors influencing the transfusion effect.

Pretransplant blood transfusions can improve kidney graft survival, but they risk sensitizing the patient. One transfusion induces the beneficial transfusion effect and has a minimal risk for sensitization. Recipients with different HLA-DR phenotypes may need different numbers of transfusions to improve graft survival. For nontransfused recipients it is important to receive a well-matched HLA-DR kidney.

Blood Transfusion↗
PubMed1987

Influence of HLA matching, donor age, and cyclosporine on unrelated pediatric renal allograft survival.

Results in this study demonstrate that HLA matching has a beneficial effect on the survival of renal allograft in pediatric recipients. The introduction of a child-match procedure may have led to a lower degree of HLA well-matched grafts because of the small size of the pediatric waiting list. The poor results obtained in the group of children aged less than 6 years may have been due to a difference in physical condition at the moment of transplantation. This may explain why 4 of 20 (20%) of the failures in that age-group were due to patient death. The best results with the child-match procedure were obtained if the donor and recipient were both aged between 6 and 15 years. The overall graft survival in all children was improved by the use of Cs. An increase of approximately 10% was observed in this group of patients. The numbers in this group are too small, however, to permit any meaningful analysis of the influence of Cs on HLA matching. Finally, the overall results in this report demonstrate that renal transplantation is an effective form of therapy for end-stage renal disease in children.

Adolescent↗
PubMed1986

Recognition of polymorphic monocyte antigens.

Sera from multiparous women and renal transplant recipients were screened for the presence of anti-monocyte antibodies. Reactions caused by anti-HLA antibodies were excluded by using panel cells that were HLA-compatible with the antibody producers. Six sera with monocyte-specific antibodies were identified, and at least two monocyte-specific (probably allelic) antigens could be recognized. The perspective of the clinical significance of typing for monocyte-specific antigens is discussed.

Antigen-Antibody Complex↗