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1. Priv. Doz. Dr. med. Fuat Hakan Saner, DEAA, Intensive Care Unit, Department of General, Visceral, and Trans-

plantation Surgery, University Hospital Essen, Germany

2. Professeur Raymond Reding, Hpital Saint-Luc, Unit de chirurgie pdiatrique abdominale et gnrale,

Bruxelles, Belgique

3. Prof. Dr. Johan W. de Fijter, MD, PhD, Leiden University Medical Center, Leiden, The Netherlands

4. Prof. Erich Pohanka, Division of Nephrology and Dialysis, Internal Medicine III, Medizinische Universitt Wien,

Vienna A-1090, Austria

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1. Tullius SG, Tilney NL. Both alloantigen-dependent

and -independent factors influence chronic allograftrejection. Transplantation 1995 Feb 15;59:313-8.

2. Terasaki PI, Cecka JM, Gjertson DW, Cho YW. Spou-sal and other living renal donor transplants. ClinTranspl 1997: 269-284.

3. Cosio FG, Qiu W, Henry MK. Factors related to thedonor organ are major determinants of renal allograftfunction and survival. Transplantation 1996: 62: 157

4. Roodnat JL, van Riemsdijk IC, Mulder PG, et al.: Thesuperior results of livingdonor renal transplantationare not completely caused by selection or short coldischemia time: a single-center, multivariate analysis.Transplantation 2003, 75:20142018.

5. Pratschke J, Wilhelm MJ, Kusaka M, et al.: Accele-rated rejection of rat renal allografts from brain deaddonors. Ann Surg 2000, 232:263271.


6. van der Hoeven JA, Lindell S, van Schilfgaarde R, etal.: Donor brain death reduces survival after transplan-tation in rat livers preserved for 20 hr. Transplantation2001, 72:16321636.

7. Wilhelm MJ, Pratschke J, Kusaka M, et al.: Donorbrain death affects tempo and intensity of acuterejection of rat cardiac allografts. Trans Proc 1999,31:10081009.

8. Schuurs TA, Gerbens F, van der Hoeven JA, et al.Distinct transcriptional changes in donor kidneys uponbrain death induction in rats: insights in the process ofbrain death. Am J Transplant 2004; 4: 1972.

9. Hammer MD, Crippen D. Brain death and withdrawalof support. Surg Clin North Am. 2006 Dec; 86: 1541-51.

10. Black PM. Pathophysiology of brain death: intracranialaspects. Transplant Proc. 1988 Oct; 20 (Suppl 7): 21-4.

11. Mertes PM: Physiology of brain death. In: Tilney NL,Strom TB, Paul LC, editors. Transplantation Biology:Cellular and Molecular Aspects. Philadelphia:Lippincott-Raven Publishers; 1996: 275289.

12. Takada M, Nadeau KC, Hancock WW, et al. Effects ofexplosive brain death on cytokine activation of periphe-ral organs in the rat. Transplantation 1998; 65: 1533.

13. Shivalkar B, Van Loon J, Wieland W, et al. Variableeffects of explosive or gradual increase of intracranialpressure on myocardial structure and function.Circulation 1992; 87: 230.

14. Nijboer WN, Schuurs TA, van der Hoeven JA, PloegRJ. Effect of brain death and donor treatment on or-gan inflammatory response and donor organ viability.Curr Opin Organ Transplant 2004; 9: 110-115.

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17. Baroldi G, Di Pasquale G, Silver MD, Pinelli G, LusaAM, Fineschi V. Type and extent of myocardial injuryrelated to brain damage and its significance in hearttransplantation: a morphometric study. J Heart LungTransplant. 1997 Oct; 16: 994-1000.

18. Wilhelm MJ, Pratschke J, Laskowski IA, Paz DM,Tilney NL. Brain death and its impact on the donorheart-lessons from animal models. J Heart LungTransplant. 2000 May; 19: 414-8.

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20. Szabo G, Buhmann V, Bahrle S, et al. Brain deathimpairs coronary endothelial function. Transplantation2002; 73: 1846-1848.

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and myocardial injury: role of cardiac sympathetic in-nervation evaluated by in vivo interstitial microdialysis.Transplant Proc 1994; 26: 231-232.

22. Cantin B, Kwok BW, Chan MC, et al. The impact ofbrain death on survival after heart transplantation: ti-me is of the essence. Transplantation 2003; 76: 1275-9.

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25. Nagareda T, Kinoshita Y, Tanaka A, et al. Clinicopa-thology of kidneys from brain dead patients treatedwith vasopressin and epinephrine. Kidney Int 1993; 43:1363-70.

26. Wicomb WN, Cooper DK, Novitzky D. Impairment ofrenal slice function following brain death, with reversi-bility of injury by hormonal therapy. Transplantation1986; 41: 29-33.

27. van der Hoeven JA, Molema G, Ter Horst GJ, et al.Relationship between duration of brain death andhemodynamic (in)stability on progressive dysfunctionand increased immunologic activation of donorkidneys. Kidney Int 2003; 64: 1874-82.

28. Pratschke J, Wilhelm MJ, Kusaka M, et al.: Accelera-ted rejection of renal allografts from brain-dead do-nors. Ann Surg 2000, 232:263271.

29. Okamoto S, Corso CN, Nolte D, et al. Impact of braindeath on hormonal homeostasis and hepatic microcir-culation of transplant organ donors. Transpl Int 1998;11: S 404-7.

30. Nagareda T, Kinoshita Y, Tanaka A, Hasuike Y,Terada N, Nishizawa Y, Fujita MQ, Kuroda H, YawataK, Aozasa K, et al. Clinicopathological study of liversfrom brain dead patients treated with a combination ofvasopressin and epinephrine. Transplantation. 1989May; 47: 792-7.

31. Toyama H, Takada M, Suzuki Y, et al. Brain deathin-duced expression of ICAM-1 and VCAM-1 on rathepatocytes. Hepatogastroenterology 2003; 50: 1854-6.

32. Jassem W, Koo DD, Cerundolo L, et al. Leukocyteinfiltration and inflammatory antigen expression incadaveric and living-donor livers before transplant.Transplantation 2003; 75: 2001.

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38 N. ANTNIAH


35. Wilhelm MJ, Pratschke J, Beato F, et al. Activation ofthe heart by donor brain death accelerates acuterejection after transplantation. Circulation 2000; 102:2426.

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37. Contreras JL, Eckstein C, Smyth CA, et al. Brain deathsignificantly reduces isolated pancreatic islet yields andfunctionality in vitro and in vivo after transplantationin rats. Diabetes 2003; 52: 2935.

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47. Hunt SA, Baldwin J, Baumgartner W, et al. Cardio-vascular management of a potential heart donor: astatement from the transplantation committee of theAmerican College of Cardiology. Crit Care Med 1996;24: 1599-601.

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1. Criteria for the diagnosis of brain stem death. Working

Party Review. J R Coll Phys (1995); 29:381-2.

2. Gore SM, Ross Taylor RM, Wallwork J. Availability oftransplantable organs from brain stem death donors inintensive care units. Br Med J (1991); 302:149-53.

3. Heaton ND. Organ donation: logistics and technicalaspects (1997). In: John L.R. Forsythe (editor). Trans-plantation Surgery. W.B. Saunders Company Ltd.

4. Kootstra G, Daemen JHC, Oowen APA. Categories ofnon-heart beating donors. Transplant Proc (1995);27:2893-95.

5. Casavilla A, Ramirez C, Shapiro R et al. Experiencewith kidney and liver allografts from non-heart beatingdonors. Transplantation (1995); 59:197-203.

6. Muiesan P, Girlanda R, Baker A et al. Successful seg-mental auxiliary liver transplantation from a non-heartbeating donor: implications for split liver transplanta-tion. Transplantation (2003); 75(9):1443-5.

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1. Sells, R.A. Proceedings of the Ethics Committee of the

Transplantation Society 1990 1992. The Transplanta-tion Society Bulletin, August 1993.

2. Principles of Health Care Ethics. Gillon R (ed). JohnWiley and Sons 1994.

3. Joralemon D. Shifting ethics: debating the incentivequestion in organ transplantation. Journal of MedicalEthics 2001.

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1. Sanchez-Miret JI., Hernandez JO., Procaccio F.: Do-

nor maintenance in Transplant coordination manual,pp 113-133, ed TPM-Les Heures Universitat deBarcelona, Barcelona 2001.

2. Kutsogiannis D. Pagliarello G., Doig C., Ross H.,Shemic S: Medical management to optimize donororgan potential: review of the literature. Can J Anesth2006; 53(8):820-830

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4. Rosendale J., Chabalewski F., McBride M., et al: In-creased transplanted organs from the use of standar-dized donor management protocol. Am J Transplant2002; 2:761-8

5. Edgar P., Bullock R., Bonner S.: Management of theheart-beating organ donor. BJA: CEACCP 2004;4(3):86-90

6. Tuttle- Newhall J., Collins B.,Kuo P., Schoeder R.: Or-gan donation and treatment of the multi-organ donor.Curr Probl Surg 2003;40:266-310

7. Vaireti M., Ferrigno A., Rizzo V., et al: Liver damageduring ischemia /reperfusion and glutathione: implica-tions for potentialorgan donors. Transplant proc.2007;39(6):1768-70

8. Khush KK.,Menza R., Babcock W., Zaroff: Donor car-diac troponin I levels do not predict recipient survivalafter cardiac transplantation. J Heart Lung Transplant2007;26(10): 1048-53

9. Roels I., Pirenne J., Delooz H., Lauwers P., Vander-meersch E: Effect of triiodothyronine replacementtherapy on maintenance characteristics and organavailability in hemodynamically unstable donors.Transplant proc 2000; 32 :1564-6

10. Mullis Jansson S., Argenziano M., Corwin S., et al: Arandomized double blind study of the effect of triiodo-thyronine on cardiac function and morbidity aftercoronary bypass surgery. J Thorac Cardiovsc Surg1999; 117:1128-35

11. Rosendale J., Kauffman H., McBride m., et al: Hormo-nal resuscitation yields more transplanted hearts , withimproved early function. Transplantation 2003;75:1336-41

52 M. MITZANH

METAMOXEYH NEPOYIOENEI OIMEI

53

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55

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1

-, - , , , - .

1. Webb NJA, Johnson R, Postlethwaite R. Renal Trans-

plantation. Arch Dis Chld 2003;88 844-847

2. Tejani A, Harmon W. Clinical Transplantation. In Bar-

ratt M, Anver E, Harmon W eds. Pediatric Nephrolo-gy. 4th ed. Baltimore; Lippincot Williams and Wilkins1999;1309-1337.

3. Seikaly M, Ho P, Emmett L, Fine R, Tejani A. Chronicrenal insufficiency in children: The 2001 Annual Reporof the NAPRTCS. Pediatr Nephrol 2003; 18:796-804.

4. Seikaly M, Ho P, Emmett L, et al. The 12th AnnualReport of the North American Pediatric Renal Trans-plant Cooperative Study: renal transplantation from1987 through 1998. Pediatr Transplant 2001;5:215-231

5. Smith J, et al. Contributions of the Transplant Re-gistry: The 2006 Annual Report of the North AmericanPediatric Renal Trials and Collaborative Studies.Pediatric Transplant 2007; 11:366-373.

56 . AAXPHTOY

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) O

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5) (SPKT)

- , 1993 Diabetes Control andComplications Trials (DCCT) [46]. - , - - , - - , - . - -, - . -- - , - -, SPKT - - [47,48,49].

1966, - - , 85% , - (SPKT). - , - - . 10% , () (pan-creas-after-kidney transplant, PAK), 5% - (PTA), - .

-- 1 -


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, - - stem cell - [54].

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Racusen L.C., Colvin R.B. et al. Antibody Mediated

Rejection Criteria an Addition to the Banff 97 Classi-fication of Renal Allograft Rejection. Am J Transplant2003; 3: 708-714.

Solez K., Colvin R.B. et al. Banff 05 Meeting Report:Differential Diagnosis of Chronic Allograft Injury andElimination of Chronic Allograft Nephropathy (CAN).Am J Transplant 2007; 7:518-526.

Colvin RB, Nickeleit V. Renal Transplant Pathology. InHeptinstalls Pathology of the Kidney 2007, pp 1347-1490.

Colvin R.B. Renal Transplant Pathology. AmericanCongress of Renal Pathology 2005, pp 259-282.

Mengel M., Bogers J. et al. Incidence of C4d Stain inProtocol Biopsies from Renal Allografts: Results from aMulticener Trial. Am J Transplant 2005; 5:1050-1056.

Haas M., Rahman M.H. et al. C4d and C3d Staining inBiopsies of ABO and HLA Incompatible Renal

70 M. EONTINH

Allografts: Correlation with Histologic Findings. Am JTransplant 2007; 7: 724-724 (1)

Nankivell B.J. and Chapman J.R. The Significance ofSubclinical Rejection and the Value of Protocol Biop-sies. Am J Transplant 2006; 6:2006-2012.

Cornell L.D., Colvin R.B. Chronic allograft nephro-pathy. Curr Opin Nephrol Hypertens 2005; 14:229-234.

Hara S. Matsushita H., et al. Allograft Glomerulitis: Hi-stologic Characteristics to Detect Chronic Humoral Re-jection. Transplant Proc 2005;37:714-716.

Mauiyyedi S., Crespo M. et al. Acute Humoral Rejectionin Kidney Transplantation: Morphology, Immunopatho-logy and Pathologic Classification. J Am Soc Nephrol2002; 13:779-787.

Regele H., Bohmig G.A. et al. Capillary Deposition ofComplement Split Product C4d in Renal Allografts in

Associated with Basement Membrane Injury in Peri-tubular and Glomerular Capillaries: A contribution ofHummoral Immunity to Chronic Allograft Rejection. JAm Soc Nephrol 2002; 13:2371-2380.

Feucht H.E., Mihatsch M.J. Diagnostic value of C4d inrenal biopsies. Curr Opin Nephrol Hypertens 2005; 14:592-598.

Racusen L.C. Molecular Techniques in Transplantation.Transplant Proc 2004; 36:731-732.

Sarwal M., Chua M.S. et al. Molecular heterogeneity inacute renal allograft rejection identified by DNAmicroarray profiling. N Engl J Med 2003; 349:125-138.

Chicano S.L., Cornell L.D. et al. distinctive ultrastructu-ral features of chronic allograft glomerulopathy: newformation of circumferential glomerular basement mem-brane. Lab Invest 2006; 86 (Suppl. 1).


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, - . , - , , - - .

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18. Meier-Kriesche HU, Steffen BJ, Hochberg AM, et al.Long-term use of mycophenolate mofetil is associatedwith reduction in the incidence and the risk of laterejection. Am J Transplant 2003;3:68-73

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impact of nonadherence to immunosuppressants afterrenal transplantation: a systematic review. Transplan-tation 2004; 77:769-76

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24. Lazzeri E, Rotondi M, Mazzinghi B, et al. HighCXCL10 expression in rejected kidneys and predictiverole of pretransplant serum CXCL10 for acute reje-ction and chronic allograft nephropathy Transplanta-tion 2005 15;79:1215-20

25. Macias-Nunez J, Cameron JS. The ageing kidney. InDavidson A, Cameron JS, Grunfeld JP, et al., edsOxford Textbook of Clinical Nephrology. Oxford:Oxford University Press, 2005;I:73-87

26. Feutren G, Mihatsch MJ Risk factors for cyclosporine-induced nephropathy in patients with autoimmunediseases. International Kidney Biopsy Registry ofCyclosporine in Autoimmune Diseases. N Engl J Med.1992;326:1654-60

27. Gourishankar S, Melk A, Halloran P. Nonimmune me-chanisms of injury in renal transplantation. TransplantRev 2002;16:73-86

28. Ojo AO, Leichtman AB, Punch JD , et al. Impact ofpre-existing donor hypertension and diabetes mellituson cadaveric renal transplant outcomes.Am J KidneyDis2000;36:153-9

29. Opelz G, Dohler B. Collaborative Transplant Study.Improved long-term outcomes after renal transplanta-tion associated with blood pressure control.Am JTransplant 2005;5:2725-31

30. Geddes CC, Woo YM, Jardine AG .The impact ofdelayed graft function on the long-term outcome ofrenal transplantation.J Nephrol 2002;15:17-21

31. Hetzel GR, Klein B, Brause M, et al. Risk factors fordelayed graft function after renal transplantation andtheir significance for long-term clinical outcome.Transpl Int 2002b;15:10-6

32. Andrade CF, Waddell TK, Keshavjee S, Liu M .Innateimmunity and organ transplantation: the potential roleof toll-like receptors.Am J Transplant 2005;5:969-75

33. Land WG .The role of postischemic reperfusion injuryand other nonantigen-dependent inflammatory path-ways in transplantation. Transplantation 2005, 15; 79:505-14

34. Koo DDH, Welsh KI, McLaren J, et al. Cadaver versusliving donor kidneys: impact of donor factors onantigen induction before transplantation. Kidney Int1999;56:1551-59

35. Gjertson DW, Cecka JM. Living unrelated kidneytransplantation. Kidney Int 2000;58:491-99

36. Pratschke J, Wilhelm MJ, Laskowski I, et al. Influenceof donor brain death on chronic rejection of renaltransplants in rats.J Am Soc Nephrol 2001;12:2474-81

37. Meier-Kriesche HU, Arndorfer JA, Kaplan B.The im-

pact of body mass index on renal transplant outcomes:a significant independent risk factor for graft failureand patient death.Transplantation 2002a;73:70-4

38. Kasiske BL, Snyder JJ, Gilbertson D. Inadequatedonor size in cadaver kidney transplantation.J Am SocNephrol 2002b;13:2152-9

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40. Segoloni GP, Messina M, Squiccimarro G, et al.Preferential allocation of marginal kidney allografts toelderly recipients combined with modified immunosup-pression gives good results.Transplantation 2005; 80:953-58

41. Schwarz A, Mengel M, Gwinner W, et al. Risk factorsfor chronic allograft nephropathy after renal transplan-tation: a protocol biopsy study.Kidney Int 2005;67:341-48

42. Tong CY, Bakran A, Peiris JS, et al. The association ofviral infection and chronic allograft nephropathy withgraft dysfunction after renal transplantation. Trans-plantation 2002;74:576-78

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50. Mihatsch MJ, Morozumi K, Strom EH, et al. Renaltransplant morphology after long-term therapy withcyclosporine.Transplant Proc 1995;27:39-42


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- - . . - - -. ( , de novo - ) - .

- , - , , - , , , - , - , (, , ) - .

1. Nankivell BJ, Borrows R, Fung C, et al. The natural

history of chronic allograft nephropathy. N Engl J Med2003; 349:2326-2332.

2. Pascual M, Theruvath T, Kawai T, et al. Strategies toimprove long term outcomes after renal transplanta-tion. N Engl J Med 2002; 346:580-590.

3. Matas A, Humar A, Gillingham K et al. Five preven-table causes of kidney graft loss in 1990s: a single cen-ter analysis. Kidney Inte 2002;62:704-708.

4. Colvin RB. Chronic allograft nephropathy. N Engl JMed 2003; 349:2287-2291.


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