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Failing renal graft

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https://www.readbyqxmd.com/read/28423997/do-lipid-microemboli-induce-acute-kidney-injury-during-cardiopulmonary-bypass
#1
Richard Issitt, Tim James, Bronagh Walsh, David Voegeli
BACKGROUND: Acute kidney injury (AKI) following cardiopulmonary bypass affects 5% of patients, representing significant postoperative morbidity and mortality. Animal models have shown an increased uptake of lipid microemboli (LME) into the renal vasculature, potentially indicating ischaemic causation. This study tested a new lipid filtration system (RemoweLL) against a conventional system with no lipid-depleting capacity to determine the efficacy of the filtration system and its effects on renal function...
April 1, 2017: Perfusion
https://www.readbyqxmd.com/read/28392056/open-conversion-after-endovascular-abdominal-aneurysm-repair-an-8-year-single-centre-experience
#2
I Ben Abdallah, S El Batti, M Abou-Rjeili, J-N Fabiani, P Julia, J-M Alsac
OBJECTIVE: To report experience with open conversion (OC) after previous failed EVAR and to compare outcomes of patients undergoing elective OC with those operated on in an urgent setting. METHODS: Patients undergoing OC after EVAR between August 2008 and September 2016 were included in this retrospective and observational single institution study. Indications, demographic, anatomical, intra-operative and post-operative data were collected prospectively. Primary endpoints were 30 day and in hospital mortality...
April 5, 2017: European Journal of Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/28353491/nonprogrammed-vascular-access-is-associated-with-greater-mortality-in-patients-who-return-to-hemodialysis-with-a-failing-renal-graft
#3
Gustavo Laham, Gervasio Soler Pujol, Antonio Vilches, Ana Cusumano, Carlos Diaz
BACKGROUND: In incident hemodialysis (HD) patients the use of catheters is associated with a worse prognosis when compared to those with an arteriovenous fistula (AVF), but the role of vascular access (VA) type in the morbidity and mortality of patients returning to HD with a failing renal allograft is unknown. We aimed to determine the associations between the type of vascular access and mortality in this population. METHODS: This was a retrospective observational cohort study of 138 patients who initiated dialysis after kidney transplant failure between 1995 and 2014...
March 28, 2017: Transplantation
https://www.readbyqxmd.com/read/28319322/an-analysis-of-the-survival-outcomes-of-simultaneous-pancreas-and-kidney-transplantation-compared-to-live-donor-kidney-transplantation-in-patients-with-type-1-diabetes-a-uk-transplant-registry-study
#4
Adam D Barlow, Kourosh Saeb-Parsy, Christopher J E Watson
BACKGROUND: Transplant options for patients with type 1 diabetes and end-stage renal disease (ESRD) include deceased donor kidney, live donor kidney (LDK) and simultaneous pancreas-kidney (SPK) transplantation. The aim of this study was to compare outcomes between LDK and SPK for patients with type 1 diabetes and ESRD in the UK. METHODS: Data on all SPK (n=1739) and LDK (n=385) transplants performed between January 2001 and December 2014 were obtained from the UK Transplant Registry...
March 20, 2017: Transplant International: Official Journal of the European Society for Organ Transplantation
https://www.readbyqxmd.com/read/28297057/dialysis-access-issues-related-to-conversion-from-peritoneal-dialysis-to-hemodialysis-and-vice-versa
#5
Maurizio Gallieni, Antonino Giordano, Anna Ricchiuto, Davide Gobatti, Maurizio Cariati
ABSTRACTHemodialysis (HD) and peritoneal dialysis (PD) represent two complementary modalities of renal replacement therapy (RRT) for end-stage renal disease patients. Conversion between the two modalities is frequent and more likely to happen from PD to HD. Every year, 10% of PD patients convert to HD, suggesting the need for recommendations on how to proceed with the creation of a vascular access in these patients. Criteria for selecting patients who would likely fail PD, and therefore take advantage of a backup access, are undefined...
March 6, 2017: Journal of Vascular Access
https://www.readbyqxmd.com/read/28213388/effects-of-dopamine-donor-pretreatment-on-graft-survival-after-kidney-transplantation-a-randomized-trial
#6
Peter Schnuelle, Wilhelm H Schmitt, Christel Weiss, Antje Habicht, Lutz Renders, Martin Zeier, Felix Drüschler, Katharina Heller, Przemyslaw Pisarski, Bernhard Banas, Bernhard K Krämer, Matthias Jung, Kai Lopau, Christoph J Olbricht, Horst Weihprecht, Peter Schenker, Johan W De Fijter, Benito A Yard, Urs Benck
BACKGROUND AND OBJECTIVES: Donor dopamine improves initial graft function after kidney transplantation due to antioxidant properties. We investigated if a 4 µg/kg per minute continuous dopamine infusion administered after brain-death confirmation affects long-term graft survival and examined the exposure-response relationship with treatment duration. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: Five-year follow-up of 487 renal transplant patients from 60 European centers who had participated in the randomized, multicenter trial of dopamine donor pretreatment between 2004 and 2007 (ClinicalTrials...
March 7, 2017: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/28210573/emphysematous-pyelonephritis-in-a-transplanted-kidney
#7
Cristiano Claudino Oliveira, Paula Dalsoglio Garcia, Rosa Marlene Viero
Emphysematous pyelonephritis is a rare infection characterized by necrosis and gas accumulation in the renal parenchyma, adjacent tissues, and/or urinary collecting system. This entity is rarely reported in transplanted kidneys. Computed tomography imaging is necessary for diagnosis and risk classification. The authors described the case of a 58-year-old man who underwent a kidney transplant and presented sepsis from a urinary tract infection. An abdominal tomography showed some characteristics of emphysematous pyelonephritis associated with an abscess...
October 2016: Autopsy & case reports
https://www.readbyqxmd.com/read/28199785/assessment-of-tocilizumab-anti-il-6-receptor-monoclonal-as-a-potential-treatment-for-chronic-antibody-mediated-rejection-and-transplant-glomerulopathy-in-hla-sensitized-renal-allograft-recipients
#8
Jua Choi, Olivier Aubert, Ashley Vo, Alexandre Loupy, Mark Haas, Dechu Puliyanda, Irene Kim, Sabrina Louie, Alexis Kang, Alice Peng, Joe Kahwaji, Nancy Reinsmoen, Mieko Toyoda, Stanley C Jordan
Extending the functional integrity of renal allografts is the primary goal of transplant medicine. Development of donor-specific antibodies (DSAs) post-transplant leads to chronic active antibody-mediated rejection (cABMR) and transplant glomerulopathy (TG), resulting in the majority of graft losses in the U.S. This reduces the quality & length of life for patients and increases cost. There are no approved treatments for cABMR. Evidence suggests the pro-inflammatory cytokine interleukin 6 (IL-6) may play an important role in DSA generation and cABMR...
February 15, 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/28119255/limitations-of-current-liver-transplant-immunosuppressive-regimens-renal-considerations
#9
Wei Zhang, John Fung
BACKGROUND: The use of calcineurin inhibitor (CNI)-based immunosuppressive regimens following liver transplantation (LTx) has improved the outcomes of the recipients. However, CNI has nephrotoxicity and causes short- and long-term renal complications. The progressive structural changes can be irreversible in the long-term, leading to chronic kidney dysfunction. The present review was to evaluate the different strategies of CNI application to renal function in liver recipients. DATA SOURCES: PubMed database was searched for relevant articles in English on the issue of immunosuppressive regimen and kidney injury that related to early minimization of CNI after LTx...
February 2017: Hepatobiliary & Pancreatic Diseases International: HBPD INT
https://www.readbyqxmd.com/read/28115402/surgical-resection-of-a-rare-cutaneous-manifestation-of-scedosporium-apiospermum-in-a-patient-who-underwent-renal-transplant
#10
A C S Stoneham, S E Stoneham, S A Wyllie, A N Pandya
A man aged 47 years who was immunosuppressed following renal transplantation for focal segmental glomerulosclerosis was referred to the Plastic Surgery team for management of a painful, chronic, granulomatous lesion of the right forearm. Serial ultrasound scans and MRI scans were not diagnostic, but microbiological specimens tested positive for the fungus Scedosporium apiospermum The renal transplant graft-which was failing-was removed, allowing him to cease immunosuppression. He then underwent a resection of the lesion and reconstruction with a split thickness skin graft...
January 23, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28086881/dengue-fever-in-renal-transplant-patients-a-systematic-review-of-literature
#11
Ranga Migara Weerakkody, Jean Ansbel Patrick, Mohammed Hussain Rezvi Sheriff
BACKGROUND: Dengue fever in renal transplanted patients has not been studied well, and we review all the literature about episodes dengue fever in renal transplant patients. METHODS: The aim was to describe clinico-pathological characteristics, immunosuppressive protocols, need renal outcome and mortality. PubMed, LILACS, Google Scholar and Research Gate were searched for "Dengue" and "Renal/Kidney Transplantation" with no date limits. Hits were analyzed by two researchers separately...
January 13, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/28062549/redo-procedures-for-degenerated-stentless-aortic-xenografts-and-the-role-of-valve-in-valve-transcatheter-techniques
#12
Herko Grubitzsch, Sebastian Zobel, Torsten Christ, Sebastian Holinski, Karl Stangl, Sascha Treskatsch, Volkmar Falk, Michael Laule
OBJECTIVES: This study evaluates reinterventions for degenerated stentless aortic xenografts. METHODS: Between 2010 and 2015, 52 consecutive patients (age 72.3 ± 9.7 years, EuroSCORE II 11.1 ± 8.9%) underwent reintervention for failed stentless aortic valves (60% porcine, 40% pericardial, 87% sub-coronary, 81% isolated/combined regurgitation). RESULTS: Based on age, EuroSCORE II, the presence of pulmonary hypertension, renal failure, a patent internal mammary artery graft and required concomitant procedures, the heart team assigned 25 patients to reoperation and 27 to valve-in-valve transcatheter aortic valve implantation (ViV-TAVI)...
April 1, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/28058698/high-soluble-cd30-levels-and-associated-anti-hla-antibodies-in-patients-with-failed-renal-allografts
#13
Gonca E Karahan, Yasar Caliskan, Kursat Ozdilli, Cigdem Kekik, Huseyin Bakkaloglu, Bahar Caliskan, Aydin Turkmen, Mehmet S Sever, Fatma S Oguz
INTRODUCTION: Serum soluble CD30 (sCD30), a 120-kD glycoprotein that belongs to the tumor necrosis factor receptor family, has been suggested as a marker of rejection in kidney transplant patients. The aim of this study was to evaluate the relationship between sCD30 levels and anti-HLA antibodies, and to compare sCD30 levels in patients undergoing hemodialysis (HD) with and without failed renal allografts and transplant recipients with functioning grafts. METHODS: 100 patients undergoing HD with failed grafts (group 1), 100 patients undergoing HD who had never undergone transplantation (group 2), and 100 kidney transplant recipients (group 3) were included in this study...
January 13, 2017: International Journal of Artificial Organs
https://www.readbyqxmd.com/read/28054732/liver-transplantation-is-associated-with-good-clinical-outcome-in-patients-with-active-tuberculosis-and-acute-liver-failure-due-to-anti-tubercular-treatment
#14
REVIEW
Michele Bartoletti, Giulia Martelli, Sara Tedeschi, Mariacristina Morelli, Valentine Bertuzzo, Marina Tadolini, Paolo Pianta, Francesco Cristini, Maddalena Giannella, Russell E Lewis, Antonio D Pinna, Pierluigi Viale
BACKGROUND: Active tuberculosis (TB) is commonly considered a contraindication for liver transplantation (LT). However, in patients with TB who develop acute liver failure (ALF) due to toxicity induced by anti-tubercular treatment (ATT), LT could be the only opportunity for treatment. The aim of this study was to evaluate the feasibility of LT in this scenario. METHODS: We described 2 cases and comprehensively reviewed the literature finding 26 cases of LT performed in patients having a concomitant active TB and liver failure secondary to ATT toxicity...
January 5, 2017: Transplant Infectious Disease: An Official Journal of the Transplantation Society
https://www.readbyqxmd.com/read/28052095/metabolomic-profiling-in-individuals-with-a-failing-kidney-allograft
#15
Roberto Bassi, Monika A Niewczas, Luigi Biancone, Stefania Bussolino, Sai Merugumala, Sara Tezza, Francesca D'Addio, Moufida Ben Nasr, Alessandro Valderrama-Vasquez, Vera Usuelli, Valentina De Zan, Basset El Essawy, Massimo Venturini, Antonio Secchi, Francesco De Cobelli, Alexander Lin, Anil Chandraker, Paolo Fiorina
BACKGROUND: Alteration of certain metabolites may play a role in the pathophysiology of renal allograft disease. METHODS: To explore metabolomic abnormalities in individuals with a failing kidney allograft, we analyzed by liquid chromatography-mass spectrometry (LC-MS/MS; for ex vivo profiling of serum and urine) and two dimensional correlated spectroscopy (2D COSY; for in vivo study of the kidney graft) 40 subjects with varying degrees of chronic allograft dysfunction stratified by tertiles of glomerular filtration rate (GFR; T1, T2, T3)...
2017: PloS One
https://www.readbyqxmd.com/read/28005001/recurrent-urinary-tract-infection-among-renal-transplant-recipients-risk-factors-and-long-term-outcome
#16
Khaled Abdel Tawab, Osama Gheith, Torki Al Otaibi, Naryanam Nampoory, Hany Mansour, Medhat A Halim, Prasad Nair, Tarek Said, Mohamed Abdelmonem, Ayman El-Sayed, Waleed Awadain
OBJECTIVES: Urinary tract infection is the most common type of bacterial infection in kidney transplant procedures, with adverse effects on graft and patient survival. We aimed to evaluate the risk factors of recurrent urinary tract infection in renal transplant recipients and its impact on patient and graft survival. MATERIALS AND METHODS: In a cohort of 1019 patients who were transplanted between 2000 and 2010 at Hamed Al-Essa Organ Transplant Center in Kuwait, 86% developed at least 1 episode of urinary tract infection, with only 6...
December 22, 2016: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/27942395/current-outcomes-of-off-pump-coronary-artery-bypass-grafting-evidence-from-real-world-practice
#17
REVIEW
Piroze M Davierwala
Coronary artery bypass grafting (CABG) can be performed conventionally using cardiopulmonary bypass (CPB) and aortic clamping or on a beating heart (BH) without the use of CPB, the so-called off-pump CABG. Some surgeons, who are proponents of off-pump CABG, preferentially use this technique for the majority of operations, whereas others use it only in certain situations which warrant avoidance of CPB. Ever since the conception of off-pump CABG, the never-ending debate about which technique of CABG is safe and efficacious continues to date...
November 2016: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/27900974/disseminated-mycobacteria-chelonae-infection-in-a-kidney-pancreas-transplant-recipient-a-case-report-and-review-of-the-literature
#18
Shafi Malik, Ananda Ghosh, Shahid Husain
A 40-year-old male with a long-standing history of type 1 diabetes with end-stage renal failure underwent combined kidney-pancreas (KP) transplant from a standard criteria donor. Post-operative course was uncomplicated with good primary function of both transplant grafts. Induction was with thymoglobulin and maintenance immunosuppression was with tacrolimus, mycophenolate mofetil and prednisolone. Nine weeks post-transplant, the patient developed dysfunction of both grafts. Panel reactive antibody testing revealed that the patient had developed a de novo donor-specific antibody and considering an antibody-mediated rejection the patient was treated with intravenous pulse methyl prednisone 500 mg ×3 doses, IV immunoglobulin 2 mg/kg in two divided doses, and ATG 7 mg/kg (total dose of 700 mg)...
November 2016: Saudi Journal of Kidney Diseases and Transplantation
https://www.readbyqxmd.com/read/27890847/fenestrated-and-branched-stent-grafting-in-complex-aneurysmatic-aortic-disease-a-single-center-early-experience
#19
Georgios D Vourliotakis, Vasileios D Tzilalis, Panagiotis G Theodoridis, Charalampos S Stoumpos, Dimitrios G Kamvysis, Ioannis G Kantounakis
BACKGROUND: The aim of this study is to present our early experience and highlight the technical difficulties associated with the use of fenestrated and branched stent grafts to treat patients with juxtarenal abdominal aortic aneurysm (AAA), pararenal AAA, and thoracoabdominal aortic aneurysms (TAAAs). METHODS: A prospectively held database maintained at our department was queried for patients who have undergone branched and fenestrated stent grafting for AAA or TAAA treatment...
November 24, 2016: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/27888555/renal-operational-tolerance-is-associated-with-a-defect-of-blood-tfh-cells-that-exhibit-impaired-b-cell-help
#20
A Chenouard, M Chesneau, L Bui Nguyen, S Le Bot, M Cadoux, E Dugast, C Paul, S Malard-Castagnet, S Ville, P Guérif, J-P Soulillou, N Degauque, R Danger, M Giral, S Brouard
Renal operationally tolerant patients (TOL) display a defect in B cell differentiation, with a deficiency in plasma cells. Recently described, T follicular helper (Tfh) cells play a critical role in B cell differentiation. We analyzed blood Tfh subsets in TOL and transplanted patients with stable graft function under immunosuppression (STA). We observed a reduced proportion of blood activated and highly functional Tfh subsets in TOL, without affecting Tfh absolute numbers. Functionally, Tfh cells from TOL displayed a modified gene expression profile, failed to produce interleukin-21, and were unable to induce IgG production by naive B cells...
November 26, 2016: American Journal of Transplantation
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