Biomedical subjects

E C Lim

Publications and source records attributed to E C Lim.

3 recordsLinked to original sources

PubMed1991

Outcome of renal transplantation in different primary diseases.

1. Graft survival rates increased about 3-5 percentage points for patients with all primary diseases in 1989-1990. 2. Patients with different diseases had 1-year graft survival rates that varied from 73% for noninsulin-dependent diabetes (NIDDM) to 83% for IgA nephropathy (IgAN). Five-year graft survival varied from 40% for NIDDM to 66% for IgAN. 3. Our findings in Clinical Transplants 1990 that IgAN patients have a high graft survival was confirmed and 1-year graft survival improved by 5% in the last 2 years. 4. There was a 20 percentage point increase in full-time work status of patients after transplantation; 68% of patients with polycystic kidney disease (PKD) and chronic glomerulonephritis (CGN) had full-time work status after 3 years whereas patients with diabetes mellitus (DM) and atheronephrosclerosis (NS) had about 50%. 5. Good early graft function (urine output during the first 24 hours posttransplant, no dialysis within the first-week posttransplant, and no rejection episodes before discharge), predicted good 1-year graft survival for patients with different diseases but patients with NS and DM had a poorer graft survival beyond the first year posttransplant. Patients who had poor early function had 20% lower graft survival than those who had good function. However, in patients with IgAN, no urine at day 1 still resulted in graft survival comparable to those that produced urine. 6. More patients with DM were transplanted within 1 year after going into ESRD than those with other diseases. Conversely, 46% of those with NS did not get transplanted until more than 2 years after developing ESRD. 7. Only 77% of NS patients had functioning grafts at discharge compared to DM (84%), PKD (81%), IgAN (81%), and CGN (80%). 8. Black patients had a statistically significant higher incidence of anuria on the first day compared with Whites. They also had a higher incidence of dialysis and rejection during the first hospitalization. This was true for CGN, DM, PKD, and NS patients. Following excellent early function, Black CGN and DM patients had a higher incidence of rejection than White CGN and DM patients.

Cadaver↗

PubMed1991

Early graft function.

1. One-year graft survival was 83% for patients with excellent function on the first day compared with 65% for patients with poor kidney function. Patients with excellent function at 1 month had an 88% graft survival rate. 2. Patients with poor function at 1 week had lower graft survival rates than those with good function. Interestingly, those who functioned on the first day and then had poor function at 1 week had lower graft survival than those who had poor function from the first day. 3. Patients who worked full-time before transplantation had 3-5% higher 1-year graft survival compared with those who were working part-time. 4. Patients who had urine production on the first day had a 20% higher graft survival. Similar good outcomes were noted in those who did not require dialysis or have rejection episodes prior to discharge. 5. Three-month to 3-year graft survival was 30% higher for those with SCr less than 1.5 mg/dl compared to those with SCr more than 3.0 mg/dl. Patients with no rejections and no dialysis at the time of discharge had a 10% higher 3-year graft survival if Ccr was more than 90 ml/min than those with Ccr less than 60ml/min at the time of discharge. 6. Transplant patients who produced urine on the first-day posttransplant, did not require dialysis at 1 week, and had no rejection episodes by the time of discharge had the highest 1-year graft survival rates (88.7%), whereas those who had delayed function and suffered from rejection episodes had the worst graft survival (51%).(ABSTRACT TRUNCATED AT 250 WORDS)

Creatinine↗

PubMed1990

Outcome of kidney transplantation in different diseases.

A. PATIENT SURVIVAL 1. The best cadaver graft patient survival 3-years posttransplant was observed in those whose primary disease was either nephrotic syndrome (98%), renal hypoplasia (98%), renal dysplasia (98%), IgA nephropathy (96%), or medullary cystic disease (97%). The worst survival was in those with Goodpasture's syndrome (88%), hypertensive nephrosclerosis (87%), MPGN (87%), IDDM (86%), and NIDDM (85%). 2. Patient survival correlated inversely with nonimmunologic graft loss. Nonimmunologic graft loss was high in patients with hypertensive nephrosclerosis (21%), polycystic kidney disease (23%), IDDM (27%), and NIDDM (27%). 3. Females with CGN and IDDM had better patient survival than males with the same diseases. The 2-, 3-, and 5-year survivals for females with IDDM were 91%, 89%, and 87% whereas for males, they were 87%, 84%, and 81%, respectively (p = 0.01). For CGN the 2-, 3-, and 5-year survivals were 95%, 94%, and 93% for females and 93%, 91%, and 90% for males (p less than 0.01). Females with Alport's syndrome had lower patient survival rates at 1 year (86%) than males (95%, p = 0.03). B. GRAFT SURVIVAL 1. The best 3-year graft survival was in recipients whose primary pathology was IgA nephropathy with 83% for cadaver grafts and 95% for LRD grafts. This was not secondary to center effects. The worst graft survival at 3 years for cadaver kidney recipients was in those whose primary illness was NIDDM (61%), hypertensive nephrosclerosis (58%), MPGN (59%), and Goodpasture's syndrome (59%).(ABSTRACT TRUNCATED AT 250 WORDS)

Cyclosporins↗