This trial is evaluating whether Spleen Transplantation/Removal will improve 3 primary outcomes and 1 secondary outcome in patients with Positive CDC Cross-Match (B Cell Positive). Measurement will happen over the course of 3 years.
This trial requires 40 total participants across 2 different treatment groups
This trial involves 2 different treatments. Spleen Transplantation/Removal is the primary treatment being studied. Participants will all receive the same treatment. There is no placebo group. The treatments being tested are not being studied for commercial purposes.
Rejection of transplanted kidney can be prevented by adjusting immunosuppressant drug dosage, tacrolimus concentration, treatment with azathioprine or steroids, and administration of leflunomide, an immunosuppressant drug.
Most kidney transplants require immunosuppression and some require corticosteroids as well. Side effects of immunosuppression include opportunistic infection, graft-versus-host disease, and nephrotoxicity. Rejection is more common due to the recipient's lack of immunological tolerance. There is no known cure for rejection; however, new medications and a reduction in the number of antiestrogens may reduce symptoms.
The signs of rejection are as follows: rash, an itchy/irritable skin, dry mucus, swollen gums, loss of mucous membranes, and yellowish/greenish, greasy stool, which is often smelly when passing. Symptoms of infection include fever, chills, headache, feeling tired, low-grade fever, or aches and pains. Infection may take many different forms and involve the lungs, urinary tract, gastrointestinal tract, or bloodstream. Most commonly, the lungs and kidneys are affected. It can also affect the heart, brain or joints. An infected person might not show any symptoms.
In most cases, the mechanism of rejection is due to a combination of genetic and environmental factors. In a minority of cases, the rejection is due to the immune-system malfunctioning. This happens because of disease or medication. In some cases, the rejection is a result of a direct attack by the body. In other cases, it is the result of a combination of genetic and environmental factors. In particular it is usually due to a combination of the environmental factors and the genetics. In summary, if there is a problem, then there must be a problem. As it is not possible to predict in which cases there will be a problem, it is prudent to think of all possible problems a transplant patient might undergo.
Transplant rejection is a medical emergency associated with high morbidity and mortality. The diagnosis of rejection is difficult, as the presenting signs often change rapidly. To facilitate diagnosis and treatment, [kidney transplant](https://www.withpower.com/clinical-trials/kidney-transplant)ation should be offered to patients on dialysis for 6months or more.
More than four million new kidney and transplant patients receive dialysis each year in the U.S.; the data we obtained in this study provide a baseline of estimates of dialysis patients in the USA before the implementation of the 2001 NRRI protocol.
There has not been an attempt to conduct a controlled study of the spleen as part of a liver transplant. The spleen itself is harvested on the day of transplantation, and therefore it is not feasible to perform a spleen transplant/removal on a donor that goes to a hospital one week before transplant. This is similar to kidney, lung, and pancreas transplantation, which are already routinely performed. A spleen transplant/removal in liver transplantation would require one to wait an entire week before the surgery itself, causing unnecessary delays for patients, as well as putting more strain on the hospital's facilities.
In conclusion, SpTx/SpTx appears to be effective in preventing acute rejection without adverse effects when used at a low dosage for two-years after [transplant](https://www.withpower.com/clinical-trials/transplant)ation, in patients with acute-on-chronic renal failure or chronic rejection of a living kidney donors. Our follow-up indicates that most of the responders have excellent long-term outcomes comparable to those in the general population. The high-risk, older population who benefit from SpTx/SpTx requires long-term follow-up for determination of safety and efficacy. Future randomized trials will benefit from larger sample sizes to allow for better characterization of the groups, and better assessments of risks and benefits.
Spleen transplantation/removal with proper immunosuppression is an effective treatment option for selected patients with severe splenomegaly syndrome. However, graft-versus-host disease, graft failure, and opportunistic infections may occur, necessitating further investigations.
In addition to immunosuppressing agents, a number of drugs have been found to be effective against rejection: calcineurin inhibitors, mycophenolic acid, sirolimus, tacrolimus, piperacillin/tazobactam and thalidomide. There are important limitations to current therapies for treating transplant rejection. Additional research with larger trials is necessary to further assess the efficacy and safety of each agent.
This journal is a leading clinical transplant journal. It is an integral and popular part of a growing family of biomedical literature journals that have been in the forefront of advancing research of all kinds, especially advances in renal medicine. In addition to being indexed in CAB, this journal is also indexed in CAB, Elsevier Essential Medicine, Current Contents, Expanded and Science Citation Index Expanded.
At diagnosis, renal [transplant](https://www.withpower.com/clinical-trials/transplant)ation patients have increased age (mean age of 62.1 y) and a shorter creatinine-to-plasma albumin and creatinine-to-plasma albumin to serum protein ratio compared with patients with allograft dysfunction caused by rejection (64.8 y; 3.5 l/1 g ratio and 3.1 l/1 g ratio, respectively). We concluded that this difference in age may have a significant bearing on determining when allograft dysfunction has occurred.