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21 results on '"Cecka, Michael J."'

1. Clinical utility of complement-dependent C3d assay in kidney recipients presenting with late allograft dysfunction

Author

Lan, James H, Gjertson, David, Zheng, Ying, Clark, Stephanie, Investigators, DeKAF, Reed, Elaine F, and Cecka, Michael J

Subjects
Biomedical and Clinical Sciences, Clinical Sciences, Clinical Research, Kidney Disease, Organ Transplantation, Prevention, Transplantation, Adult, Biological Assay, Complement C3d, Cross-Sectional Studies, Female, Follow-Up Studies, Graft Rejection, Graft Survival, HLA Antigens, Histocompatibility Testing, Humans, Isoantibodies, Kidney Failure, Chronic, Kidney Transplantation, Male, Postoperative Complications, Prognosis, Prospective Studies, Risk Factors, Tissue Donors, alloantibody, antibody-mediated, clinical research/practice, histocompatibility, kidney transplantation/nephrology, rejection, DeKAF Investigators, Medical and Health Sciences, Surgery, Clinical sciences, Immunology
Abstract

The objective of this study was to evaluate the utility of a complement-dependent C3d assay to risk stratify donor-specific antibodies (DSA) in a multicenter cohort of kidney recipients presenting with new-onset clinical dysfunction. A total of 106 subjects with evidence of DSA at a mean period of 5.3 ± 5.0 years posttransplant underwent testing using C3d reagents. C3d positivity was strongly associated with both the peak and sum IgG DSA MFI, with 98.3% (n = 57/58) of strongly reactive sera (peak MFI > 10 000) eliciting a positive signal. Patients with C3d+ DSA had a higher creatinine (P = .03), more significant graft fibrosis (P = .035), and a faster rate of graft loss posttest compared to those with C3d- DSA (P = .05). Subanalysis of patients with low-moderate level DSA confirmed the inferior outcome associated with C3d positivity. Despite the prognostic value of C3d as a stand-alone test, the assay did not provide independent risk prediction after incorporation of graft fibrosis in a multivariate model (P = .94). Overall, C3d offered limited discriminatory value for strong DSA with peak IgG MFI > 10 000 and in patients where histologic data is available, but its utilization may be considered in those with low-moderate level DSA and where an allograft biopsy is not accessible.

Published
2018

8. The Report of a National Conference on the Wait List for Kidney Transplantation

Author

Gaston, Robert S., Danovitch, Gabriel M., Adams, Patricia L., Wynn, James J., Merion, Robert M., Deierhoi, Mark H., Metzger, Robert A., Cecka, Michael J., Harmon, William E., Leichtman, Alan B., Spital, Aaron, Blumberg, Emily, Herzog, Charles A., Wolfe, Robert A., Tyan, Dolly B., Roberts, John, Rohrer, Richard, Port, Friedrich K., and Delmonico, Francis L.

Published
2003

9. Antibody-Mediated Rejection Criteria – an Addition to the Banff ′97 Classification of Renal Allograft Rejection

Author

Racusen, Lorraine C., Colvin, Robert B., Solez, Kim, Mihatsch, Michael J., Halloran, Philip F., Campbell, Patricia M., Cecka, Michael J., Cosyns, Jean-Pierre, Demetris, Anthony J., Fishbein, Michael C., Fogo, Agnes, Furness, Peter, Gibson, Ian W., Glotz, Denis, Hayry, Pekka, Hunsickern, Lawrence, Kashgarian, Michael, Kerman, Ronald, Magil, Alex J., Montgomery, Robert, Morozumi, Kunio, Nickeleit, Volker, Randhawa, Parmjeet, Regele, Heinz, Seron, Daniel, Seshan, Surya, Sund, Stale, and Trpkov, Kiril

Published
2003

13. Antibody-mediated rejection criteria - an addition to the Banff 97 classification of renal allograft rejection.

Author

UCL - MD/MNOP - Département de morphologie normale et pathologique, Racusen, Lorraine C, Colvin, Robert B, Solez, Kim, Mihatsch, Michael J, Halloran, Philip F, Campbell, Patricia M, Cecka, Michael J, Cosyns, Jean-Pierre, Demetris, Anthony J, Fishbein, Michael C, Fogo, Agnes, Furness, Peter, Gibson, Ian W, Glotz, Denis, Hayry, Pekka, Hunsickern, Lawrence, Kashgarian, Michael, Kerman, Ronald, Magil, Alex J, Montgomery, Robert, Morozumi, Kunio, Nickeleit, Volker, Randhawa, Parmjeet, Regele, Heinz, Seron, Daniel, Seshan, Surya, Sund, Stale, Trpkov, Kiril, UCL - MD/MNOP - Département de morphologie normale et pathologique, Racusen, Lorraine C, Colvin, Robert B, Solez, Kim, Mihatsch, Michael J, Halloran, Philip F, Campbell, Patricia M, Cecka, Michael J, Cosyns, Jean-Pierre, Demetris, Anthony J, Fishbein, Michael C, Fogo, Agnes, Furness, Peter, Gibson, Ian W, Glotz, Denis, Hayry, Pekka, Hunsickern, Lawrence, Kashgarian, Michael, Kerman, Ronald, Magil, Alex J, Montgomery, Robert, Morozumi, Kunio, Nickeleit, Volker, Randhawa, Parmjeet, Regele, Heinz, Seron, Daniel, Seshan, Surya, Sund, Stale, and Trpkov, Kiril

Abstract

Antibody-mediated rejection (AbAR) is increasingly recognized in the renal allograft population, and successful therapeutic regimens have been developed to prevent and treat AbAR, enabling excellent outcomes even in patients highly sensitized to the donor prior to transplant. It has become critical to develop standardized criteria for the pathological diagnosis of AbAR. This article presents international consensus criteria for and classification of AbAR developed based on discussions held at the Sixth Banff Conference on Allograft Pathology in 2001. This classification represents a working formulation, to be revisited as additional data accumulate in this important area of renal transplantation.

Published
2003

21. THE RELATIVE EFFECTS OF FK506 AND CYCLOSPORINE ON SHORT AND LONGTERM KIDNEY GRAFT SURVIVAL1,2,3

Author

Gjertson, David W., Cecka, Michael J., and Terasaki, Paul I.

Abstract

As reported to the UNOS Kidney Transplant Registry from 1988 through 1994, 544 first cadaveric kidney graft recipients have been discharged with maintenance tacrolimus FK506 therapy. Total followup data was available on 38,057 first cadaveric kidney transplants from 224 centers reporting at least 10 grafts each to the Registry. We examined the effects of FK506 on short and longterm renal graft outcomes and compared its effect with that of cyclosporine CsA. Three drug categories FK506, CsA, and Other were defined using therapies through discharge i.e., grafts surviving more than 15 days. The 1year graft survival rate of 2366 recipients receiving Other therapies was 69.2±1.0. By comparison, both FK506 and CsA recipients demonstrated significantly improved early graft function 1yr survival rates of 91.1±1.3 and 86.6±0.2, respectively. The longterm graft survival, as measured by halflives, varied little 89 yr between Other and CsA groups, but was significantly P0.04 increased for FK506 patients to 14yrs. CsA usage was reported by all 224 transplant centers, whereas FK506 was administered at only 24 11 centers. Using multivariate methods, a drug regimen's graft survival rate was adjusted for center effects and 19 covariates. The adjusted FK506 and CsA cadaveric graft survival rates at 1 and 3 years mirrored their unadjusted rates, indicating that demographic differences did not confound our results. Based on this study, FK506 appears to be the first therapeutic agent to significantly improve longterm kidney graft survival rates.

Published
1995

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