One-third of cadaveric renal allografts is shipped between organ procurement organizations (OPOs). Movement of allografts occurs due to national sharing of HLA-matched kidneys, subsequent payback of organs, and arrangements between individual OPOs. Shipment can impact allograft survival via the level of HLA matching and the duration of cold ischemia time (CIT). Shipment and increased CIT may augment allograft immunogenicity and increase rates of acute rejection (AR).
The specific aims of this study are to examine the associations between CIT and AR, and between organ shipment and AR, in cadaveric renal allografts during the first 12 months after transplantation. ? ? Dr. Harold I. Feldman is the sponsor of this fellowship application and is the principal investigator of an ongoing NIH-sponsored, multicenter, prospective cohort study of drug compliance, race, and renal allograft survival, which has enrolled over 850 patients. We propose to analyze patient-level data from this study to examine the independent association of CIT and AR using multivariate Cox proportional hazard models. Linear and non-linear effects of CIT will be explored. In a similar modeling strategy, the independent association between allograft shipment and AR will be examined. Duration of CIT, and slow or delayed allograft function will be explored as potential mechanisms that explain any association observed between shipment and AR.

Agency
National Institute of Health (NIH)
Institute
National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)
Type
Postdoctoral Individual National Research Service Award (F32)
Project #
5F32DK062580-02
Application #
6668680
Study Section
Epidemiology and Disease Control Subcommittee 2 (EDC)
Program Officer
Rankin, Tracy L
Project Start
2003-05-01
Project End
2005-04-30
Budget Start
2004-05-01
Budget End
2005-04-30
Support Year
2
Fiscal Year
2004
Total Cost
$54,352
Indirect Cost
Name
University of Pennsylvania
Department
Internal Medicine/Medicine
Type
Schools of Medicine
DUNS #
042250712
City
Philadelphia
State
PA
Country
United States
Zip Code
19104
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Weng, Francis L; Joffe, Marshall M; Feldman, Harold I et al. (2005) Rates of completion of the medical evaluation for renal transplantation. Am J Kidney Dis 46:734-45
Weng, Francis L; Shults, Justine; Herskovitz, Rita M et al. (2005) Vitamin D insufficiency in steroid-sensitive nephrotic syndrome in remission. Pediatr Nephrol 20:56-63