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Cancer incidence in a kidney-transplanted population.

https://arctichealth.org/en/permalink/ahliterature196363
Source
Transpl Int. 2000;13 Suppl 1:S394-8
Publication Type
Article
Date
2000
Author
L. Kyllönen
K. Salmela
E. Pukkala
Author Affiliation
Department of Surgery, Helsinki University Central Hospital, Finland.
Source
Transpl Int. 2000;13 Suppl 1:S394-8
Date
2000
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Child
Drug Therapy, Combination
Female
Finland - epidemiology
Follow-Up Studies
Humans
Immunosuppressive Agents - therapeutic use
Incidence
Kidney Transplantation - immunology
Male
Neoplasms - epidemiology
Postoperative Complications
Registries
Retrospective Studies
Sex Factors
Time Factors
Abstract
A study on cancer incidence after kidney transplantation was performed using data of national transplant and cancer registries. Since 1964 up to 30 June 1997, 3440 kidney transplantations were performed on 2890 patients. From 1967 to 1997, 230 posttransplantation malignancies were found in 20,817 patient-years of follow up. The standardised incidence ratio (SIR) was 3.33 compared to the general population. The SIR was highest in skin cancer (39.2). The SIRs were high in cancers of the lip (23.0), thyroid (8.08), kidney (8.0), lower urinary tract (3.2), non-Hodgkin lymphoma (4.8), ovary (3.9) and colon (3.9). Skin cancer and lymphomas had much higher SIRs in men than in women whereas lower urinary tract cancer had a higher SIR in women. During the first 10 follow up years, life-table analysis indicates a higher cancer risk in cyclosporine-treated patients, but this may be biased by their shorter follow up as the overall SIR was equal in both groups. This population study shows the increased incidence of cancer in the transplant population and points out the importance of cancer surveillance in the years following kidney transplantation.
PubMed ID
11112040 View in PubMed
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Cancer incidence in a kidney-transplanted population.

https://arctichealth.org/en/permalink/ahliterature219069
Source
Transpl Int. 1994;7 Suppl 1:S350-2
Publication Type
Article
Date
1994
Author
L. Kyllönen
E. Pukkala
B. Eklund
Author Affiliation
Surgical Hospital, Helsinki, Finland.
Source
Transpl Int. 1994;7 Suppl 1:S350-2
Date
1994
Language
English
Publication Type
Article
Keywords
Cohort Studies
Colonic Neoplasms - epidemiology
Female
Finland - epidemiology
Follow-Up Studies
Genital Neoplasms, Female - epidemiology
Humans
Kidney Neoplasms - epidemiology
Kidney Transplantation - statistics & numerical data
Lymphoma, Non-Hodgkin - epidemiology
Male
Neoplasms - epidemiology
Postoperative Complications - epidemiology
Registries
Skin Neoplasms - epidemiology
Thyroid Neoplasms - epidemiology
Time Factors
Urinary Bladder Neoplasms - epidemiology
Abstract
The cancer incidence in all Finnish kidney-transplant recipients up to 1991 was studied. In 2090 patients 94 cancers were diagnosed, with a calculated incidence of 14.2% at 15 years' follow-up. The standardised incidence rate (SIR) compared with the entire Finnish population was 2.7, and it remained stable throughout the follow-up period. The SIR for skin cancer was 20, for thyroid cancer 11, and for kidney cancer, non Hodgkin lymphomas, cancer of the colon, bladder and female genital organs, 7, 6, 5, 4 and 3 respectively.
PubMed ID
11271249 View in PubMed
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Complications of gallstone disease in kidney transplantation patients.

https://arctichealth.org/en/permalink/ahliterature165787
Source
Nephrol Dial Transplant. 2007 Mar;22(3):886-90
Publication Type
Article
Date
Mar-2007
Author
S. Sarkio
K. Salmela
L. Kyllönen
M. Rosliakova
E. Honkanen
L. Halme
Author Affiliation
Department of Transplantation and Liver Surgery, Helsinki University Hospital, Box 263, FIN-00029 Helsinki, Finland.
Source
Nephrol Dial Transplant. 2007 Mar;22(3):886-90
Date
Mar-2007
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Aged
Cholecystectomy
Cholecystitis - epidemiology - etiology - surgery
Cholecystolithiasis - epidemiology - etiology - surgery
Female
Finland - epidemiology
Follow-Up Studies
Gallstones - complications - ultrasonography
Humans
Kidney Diseases - surgery
Kidney Transplantation - adverse effects
Male
Middle Aged
Prevalence
Prognosis
Retrospective Studies
Severity of Illness Index
Abstract
We studied the complications of gallstone disease in kidney transplantation patients and evaluated whether the screening and treatment of gallstones before acceptance to the kidney waiting list is relevant.
Complications of gallstone disease were evaluated in 1608 kidney transplantation patients on cyclosporine and long-term steroid treatment with median age 45.5 years, transplanted between 1990 and 2000. To evaluate the prevalence of cholecystolithiasis after kidney transplantation an abdominal ultrasound examination was cross-sectionally performed to a subgroup of 304 patients and the results were correlated to their serum lipid values, changes in BMI and use of statins.
Pre-transplant cholecystectomy due to cholecystolithiasis (prerequisite for acceptance to kidney waiting list) had been performed on 71 (4%) of the patients. Thirty (15%) patients with diagnosed post-transplant gallstones and four without gallstones developed biliary complications. There were 25 cases of cholecystitis of which three resulted in gallbladder perforations. Seventeen patients (50%) with biliary complications required urgent surgery and one (3%) patient died of post-operative complications. In the subgroup of ultrasound examination patients (median 7 years post-transplant follow-up) 81% of the patients had no gallstones and 9% of the patients had gallstones had developed after transplantation. Patients with pre-transplant gallstones were older (P
PubMed ID
17205965 View in PubMed
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Current characteristics and outcome of cytomegalovirus infections after kidney transplantation.

https://arctichealth.org/en/permalink/ahliterature261591
Source
Transpl Infect Dis. 2014 Aug;16(4):568-77
Publication Type
Article
Date
Aug-2014
Author
I. Helanterä
T. Schachtner
C. Hinrichs
K. Salmela
L. Kyllönen
P. Koskinen
I. Lautenschlager
P. Reinke
Source
Transpl Infect Dis. 2014 Aug;16(4):568-77
Date
Aug-2014
Language
English
Publication Type
Article
Keywords
Adult
Aged
Antiviral agents - therapeutic use
Bacterial Proteins
Cytomegalovirus Infections - drug therapy - epidemiology - etiology
Female
Finland - epidemiology
Ganciclovir - analogs & derivatives - therapeutic use
Germany
Humans
Immunosuppressive Agents - therapeutic use
Kidney Transplantation - adverse effects
Male
Middle Aged
Molecular Chaperones
Retrospective Studies
Abstract
The clinical course of cytomegalovirus (CMV) infections in the current era is poorly described. We characterized the symptoms and outcome of all CMV infections in a large cohort of kidney transplant recipients. Among 1129 kidney transplant recipients transplanted between 2004 and 2011 in Charité Universitätsmedizin Berlin and Helsinki University Hospital, 297 patients with CMV infection were characterized.
CMV disease occurred in 217/1129 patients (19.2%), and CMV infection in 297/1129 (26.3%). Gastrointestinal symptoms were recorded in 58% and fever in 47% patients with primary CMV disease, compared to 46% and 27% patients with symptomatic CMV reactivation, whereas leukopenia or thrombocytopenia were seen in only 17-28% patients, and malaise in 9-10%. Tissue-invasive CMV gastroenteritis was confirmed in 11% and CMV pneumonia in only 1% of patients with CMV disease. Only 1 patient died because of CMV infection (mortality 0.3%). Virus-related factors or the use of secondary prophylaxis did not predict the risk of recurrence, which occurred in 33% patients.
In conclusion, CMV disease remains a common problem after kidney transplantation. Gastrointestinal symptoms were common, especially in patients with primary CMV infection, whereas bone marrow suppression, hepatopathy, or malaise were seen less frequently.
Notes
Comment In: Transpl Infect Dis. 2014 Dec;16(6):1039-4125219298
PubMed ID
24966022 View in PubMed
Less detail
Source
Nephrol Dial Transplant. 1994;9(8):1204
Publication Type
Article
Date
1994
Author
K. Höckerstedt
B. Eklund
H. Isoniemi
L. Kyllönen
H. Mäkisalo
K. Salmela
J. Ahonen
Source
Nephrol Dial Transplant. 1994;9(8):1204
Date
1994
Language
English
Publication Type
Article
Keywords
Finland
Humans
Spain
Tissue and Organ Procurement
Notes
Comment On: Nephrol Dial Transplant. 1994;9(5):475-8; discussion 479-818090327
PubMed ID
7800231 View in PubMed
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Kidney transplantation from 1119 deceased donors in Finland, 1991 to 2003: impact of donor factors.

https://arctichealth.org/en/permalink/ahliterature171890
Source
Transplant Proc. 2005 Oct;37(8):3248-52
Publication Type
Article
Date
Oct-2005
Author
L. Kyllönen
J. Kahu
K. Salmela
Author Affiliation
Surgical Hospital, Helsinki University Hospital, Kasarmikatu 11-13, 00130 Helsinki, Finland. Lauri.Kyllonen@hus.fi
Source
Transplant Proc. 2005 Oct;37(8):3248-52
Date
Oct-2005
Language
English
Publication Type
Article
Keywords
Age Distribution
Analysis of Variance
Cause of Death
Female
Finland
Graft Survival
Humans
Kidney Transplantation - mortality - physiology - statistics & numerical data
Male
Middle Aged
Tissue Donors - statistics & numerical data - supply & distribution
Abstract
We assessed the effect of donor factors on the recovery and quality of cadaveric kidney transplant function. During 1991 to 2003, 2006 kidney grafts were derived from 1119 heart-beating donors in Finland. The annual mean age of donors increased from 33 to 46 years, with a significant decrease in the proportion of high-energy trauma and gunshot wounds and with an increased proportion of donors with coronary disease, hypertension, or cardiopulmonary resuscitation and surgical/radiological interventions before death. The transplant team's share of kidney retrievals increased from 50% to nearly 100%. In uni- and multivariate analyses all these factors had significant effects on the onset and quality of early graft function; however, this effect practically vanished by 1 year posttransplant. Of all studied donor factors, only donor cytomegalovirus (CMV) status significantly affected long-term survival, with donor CMV-positive grafts having 5% worse survival at 5 years. The 1-year graft survival improved from 90.9% to 96.2% and mean 1-year creatinine decreased from 121 micromol/L to 109 micromol/L during these 13 years, showing that the worsening trends in donors quality were compensated by improvements in other aspects of the process.
PubMed ID
16298561 View in PubMed
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Kidney transplantation in the elderly in Finland.

https://arctichealth.org/en/permalink/ahliterature103213
Source
Transplant Proc. 1990 Feb;22(1):163-4
Publication Type
Article
Date
Feb-1990
Author
L. Kyllönen
J. Ahonen
Author Affiliation
4th Department of Surgery, Helsinki University Central Hospital, Finland.
Source
Transplant Proc. 1990 Feb;22(1):163-4
Date
Feb-1990
Language
English
Publication Type
Article
Keywords
Aged
Finland
Histocompatibility
Humans
Kidney Transplantation
Middle Aged
PubMed ID
2309300 View in PubMed
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Renal transplantation in Helsinki: influence on long-term survival of early posttransplant factors.

https://arctichealth.org/en/permalink/ahliterature196873
Source
Clin Transpl. 1999;:173-9
Publication Type
Article
Date
1999
Author
K. Salmela
L. Kyllönen
Author Affiliation
4th Department of Surgery, Helsinki University Central Hospital, Finland.
Source
Clin Transpl. 1999;:173-9
Date
1999
Language
English
Publication Type
Article
Keywords
Adult
Cadaver
Cyclosporine - pharmacokinetics - therapeutic use
Follow-Up Studies
Graft Rejection - epidemiology
Graft Survival
Histocompatibility testing
Humans
Immunosuppressive Agents - pharmacokinetics - therapeutic use
Kidney Transplantation - mortality - physiology - statistics & numerical data
Retrospective Studies
Survivors
Sweden
Time Factors
Tissue Donors
Abstract
1. The half-life of kidney grafts performed at Helsinki University Central Hospital has tripled from 6.5 years in 1980-84 to 17.1 years in the 1990's. 2. Delayed graft function constitutes a significant determinant of later kidney graft survival. Five-year graft survival was 81% for patients with early graft function and 71% for those with DGF. 3. High (> 350 mg/L) early (10 +/- 2 days after transplantation) cyclosporine trough levels were associated with inferior long-term graft survival. The 5-year graft survival rate was 74% compared with 86% for patients with trough levels between 250-349 mg/L. 4. Posttransplant conversion of the crossmatch test against the kidney donor, especially in association with DGF, indicates a group with significantly worse prognosis. Among 76 patients who developed antidonor antibody after transplantation, half experienced an acute rejection within 100 days and the 5-year graft survival rate was 68% compared with 83% for non-converters.
PubMed ID
11038635 View in PubMed
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Source
Transplant Proc. 2010 Dec;42(10):4429-31
Publication Type
Article
Date
Dec-2010
Author
N. Grunnet
M. Bödvarsson
A. Jakobsen
L. Kyllönen
M. Olausson
P. Pfeffer
S Schwartz Sørensen
Author Affiliation
Department of Clinical Immunology, Scandiatransplant, Aarhus University Hospital, Aarhus, Denmark. grunnet@scandiatransplant.org
Source
Transplant Proc. 2010 Dec;42(10):4429-31
Date
Dec-2010
Language
English
Publication Type
Article
Abstract
Scandiatransplant is the Nordic organ exchange organization that has existed for 41 years by a close collaboration between transplant centers. It has been valuable to ensure the optimal usage of available organs for transplantation. Analyzing the database for the past 15 years (1995-2009) revealed that the fraction of organ donors in the age category 60 to 90 years has increased considerably. The number of retrieved organs from deceased donors increased for kidney, liver, and lungs but only slightly for hearts. In the last time period, the mean number of organs retrieved per deceased donor counting only those having a recipient increased to 3.7 for younger donors and to 2.6 from the older group. In 2009, the STAMP (Scandiatransplant acceptable mismatch program) was launched to help highly immunized kidney patients. In 2009, kidney transplantations exhibited for Norway, 60 per million people (pmp); more than 40 pmp for Sweden and for Denmark; approximately 35 pmp for Finland; and more than 20 pmp for the living donor kidney transplantations in Iceland. The best year ever within Scandiatransplant with respect to total number of organ transplantations from deceased and living donors was 2009.
PubMed ID
21168712 View in PubMed
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13 records – page 1 of 2.