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https://www.readbyqxmd.com/read/27900974/disseminated-mycobacteria-chelonae-infection-in-a-kidney-pancreas-transplant-recipient-a-case-report-and-review-of-the-literature
#1
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
#2
Georgios D Vourliotakis, Vasileios D Tzilalis, Panagiotis G Theodoridis, Charalampos S Stoumpos, Dimitrios G Kamvysis, Giannis G Kantounakis
PURPOSE: To present our early experience and highlight the technical difficulties associated with the use of fenestrated and branched stent-grafts to treat patients with juxta-, para-renal abdominal aortic aneurysms (AAA) and thoracoabdominal aortic aneurysms (TAAA). 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. Indication for repair, co-morbidity precluding open repair, technical challenges associated with the repair, as well as operative mortality, morbidity and re-intervention rate were evaluated...
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
#3
Alexis Chenouard, Mélanie Chesneau, Linh Bui Nguyen, Sabine Le Bot, Marion Cadoux, Emilie Dugast, Chloé Paul, Stéphanie Malard-Castagnet, Simon Ville, Pierrick Guérif, Jean-Paul Soulillou, Nicolas Degauque, Richard Danger, Magali Giral, Sophie Brouard
Renal operationally tolerant patients (TOL) display a defect in B cell differentiation, with a deficiency in plasma cells. Recently described, T follicular helper cells (Tfh) 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 from TOL displayed a modified gene expression profile, failed to produce IL-21 and were unable to induce IgG production by naive B cells...
November 26, 2016: American Journal of Transplantation
https://www.readbyqxmd.com/read/27805505/challenges-for-renal-retransplant-an-overview
#4
Mohamed Adel Bakr, Ahmed Abdelfattah Denewar, Mohamed Hamed Abbas
Despite many achievements in renal transplant in the past few years regarding immunosuppression and tissue matching, the rates of early and late graft loss and return to dialysis are still high. Many of those with primary graft failure will be listed for a kidney retransplant, as this allows for better quality of life than dialysis. Many challenges face those requiring renal retransplant, including first graft nephrectomy and whether site of retransplant should be ipsilateral or contralateral, whether to conduct preemptive retransplant or wait while on dialysis, additional immunologic factors, immunosuppression after retransplant, cancer risk, BK virus infection, and retransplant in pediatrics...
November 2016: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/27798381/endovascular-aneurysm-sealing-evas-and-chimney-evas-in-the-treatment-of-failed-endovascular-aneurysm-repairs
#5
Marwan Youssef, Sebastian Zerwes, Rudolf Jakob, Oroa Salem, Fritz Dünschede, Christian F Vahl, Bernhard Dorweiler
PURPOSE: To assess the technical success and clinical outcome of reinterventions using the Nellix Endovascular Aneurysm Sealing (EVAS) System to treat complications after endovascular aneurysm repair (EVAR). METHODS: Fifteen consecutive patients (mean age 79 years; 14 men) with prior EVAR were treated with EVAS between March 2014 and December 2015 at 2 institutions. The failed prior EVARs included 13 bifurcated endografts, 1 bifurcated graft plus fenestrated cuff, and 1 tube endograft...
October 26, 2016: Journal of Endovascular Therapy
https://www.readbyqxmd.com/read/27725333/-the-use-of-ureteral-stents-and-catheters-in-renal-transplantation
#6
V Gómez-Dos Santos, V Díez-Nicolás, L Martínez-Arcos, J J Fabuel-Alcañiz, I Laso-García, S Álvarez-Rodríguez, F de Asís Donis-Canet, V Hevia-Palacios, M Ruiz-Hernández, F J Burgos-Revilla
: Mayor urological complications, fistulae and stenosis, mainly affect the vesicoureteral anastomosis and present in the early post-transplant period. The systematic use of ureteral catheters keeps selecbeing controversial with many groups using them only selectively depending on the existence of pretransplant or intraoperative risk factors. METHODS: We performed a bibliographic review through automatized search in the Medline bibliographic database, as the main bibliographic source, and also in Clinical Key...
October 2016: Archivos Españoles de Urología
https://www.readbyqxmd.com/read/27717279/successful-renal-retransplantation-after-graft-loss-from-bk-polyomavirus-infection-in-a-human-immunodeficiency-virus-positive-patient
#7
Aurore Barthélemy, Nicolas Bouvier, Renaud Verdon, Valérie Chatelet, Bruno Hurault de Ligny
We report the case of a human immunodeficiency virus-seropositive patient whose initial kidney transplant failed because of BK polyomavirus-induced nephropathy, and who underwent a second transplantation 3 years later. BK viruria was detected 1 day after transplantation. After 1 month, BK viremia developed along with a donor-specific antibody. After decreasing tacrolimus and mycophenolic acid and 2 courses of intravenous immunoglobulins, BK viremia and donor-specific antibody permanently disappeared, with stable renal function...
September 26, 2016: Transplant Infectious Disease: An Official Journal of the Transplantation Society
https://www.readbyqxmd.com/read/27641051/second-vascular-access-after-failure-of-the-first-fistula-in-the-elderly%C3%A2
#8
Tammy Hod, Alexander S Goldfarb-Rumyantzev, Bhanu K Patibandla, Akshita Narra, Robert S Brown
BACKGROUND: In patients with failure of an initial arteriovenous fistula (AVF), a subsequent vascular access is needed before hemodialysis (HD) initiation. METHODS: To assess the optimal access strategy after a failed AVF, we linked data from the US Renal Data System with Medicare claims data identifying 21,436 patients ≥ 67 years old who started HD between January 1, 2005, and December 31, 2008, with an AVF placed as their first predialysis access. Of the 10,568 subjects whose AVF failed, 1,796 patients had an AVF placed as a second access predialysis (AVF2 group) and 399 patients had an arteriovenous graft placed as a second access predialysis (AVG2 group)...
November 2016: Clinical Nephrology
https://www.readbyqxmd.com/read/27623348/long-term-outcome-after-early-cyclosporine-withdrawal-in-kidney-transplantation-ten-years-after
#9
Nahid Tabibzadeh, François Glowacki, Marie Frimat, Vincent Elsermans, François Provôt, Arnaud Lionet, Viviane Gnemmi, Alexandre Hertig, Christian Noël, Marc Hazzan
BACKGROUND: Despite long-term side effects, calcineurin inhibitors (CNI) remain a cornerstone of immunosuppression in renal transplantation. Few trials assessed the long-term outcome after early CNI withdrawal. METHODS: This intention-to-treat study assessed the 10-year outcome of 108 patients randomly converted from a cyclosporine (CsA)-mycophenolate mofetil (MMF)-prednisone regimen to a dual therapy (CsA-prednisone or MMF-prednisone) at 3 months postgraft. RESULTS: At 10 years, 3...
September 13, 2016: Clinical Transplantation
https://www.readbyqxmd.com/read/27588751/from-zero-to-hero-saving-lives-one-hero-at-a-time
#10
Dr Charlotte Ratcliff, Miss Monica Hansrani
INTRODUCTION: This case report intends to highlight the Haemodialysis Reliable Outflow (HeRO) graft as a potential long term option for ongoing dialysis in patients with central venous stenosis. PRESENTATION OF CASE: A 55year old patient, who developed end stage renal failure (ESRF) after chemotherapy treatment for breast cancer, presented at the limit of her dialysis access after a 15year haemodialysis history causing central vein stenosis. The patient was initially started on peritoneal dialysis but after repeated peritonitis was switched to haemodialysis...
2016: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/27565586/endovascular-treatment-of-aneurysms-using-fenestrated-branched-endografts-with-distal-inverted-iliac-limbs
#11
Vikalp Jain, Peter Banga, Raghuveer Vallabhaneni, Matthew Eagleton, Gustavo Oderich, Mark A Farber
BACKGROUND/OBJECTIVE: Open aortoiliac grafts have typically been constructed with a short aortic bifurcation sewn near or to the visceral vessels to avoid limb kinking. Similarly, the majority of endovascular bifurcated stent grafts have short aortic main body ranging from 3 to 5 cm. In these patients, endovascular salvage with fenestrated stent grafts is technically challenging because of the short distance between the renal arteries and the flow divider of the graft. Custom fenestrated stent grafts can be extended into the prior open surgical graft or stent graft using a short distal bifurcated stent graft with inverted iliac limb for the contralateral gate...
September 2016: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/27505010/renal-autotransplantation-at-three-academic-institutions-in-turkey
#12
Yarkin Kamil Yakupoglu, Fazil Tuncay Aki, Yakup Kordan, Ender Ozden, Senol Tonyali, Yakup Bostanci, Hakan Vuruskan, Cenk Yucel Bilen, Saban Sarikaya
OBJECTIVE: The objective of this study is to present the experience of 3 institutions performing renal autotransplantation (RAT) and to discuss surgical techniques employed and the results in the light of the medical literature. MATERIALS AND METHODS: A total of 14 patients (11 male and 3 female) with a mean age of 47 ± 8 years (35-61 years), who underwent RAT procedure at 3 different institutions between October 2006 and November 2014, in Turkey, were evaluated retrospectively...
2016: Urologia Internationalis
https://www.readbyqxmd.com/read/27457730/when-is-transplantation-with-a-marginal-kidney-justifiable
#13
Alireza Heidary Rouchi, Mitra Mahdavi-Mazdeh
The ability of kidney transplantation to improve quality of life has made this therapeutic modality the treatment of choice among renal replacement therapies; however, the continuing organ shortage has forced the use of marginal kidneys as a supplementary source of allografts. It has been repeatedly suggested that failed kidney transplant recipients have greater morbidity and mortality compared with dialysis patients with no renal transplant history. Achieving an optimal balance between the advantages of kidney transplant and disadvantages of allografts with marginal quality is a topic of controversy in transplant medicine...
July 26, 2016: Annals of Transplantation: Quarterly of the Polish Transplantation Society
https://www.readbyqxmd.com/read/27444362/a-comparison-of-patency-and-interventions-in-thigh-versus-hemodialysis-reliable-outflow-grafts-for-chronic-hemodialysis-vascular-access
#14
Evan R Brownie, Clark D Kensinger, Irene D Feurer, Derek E Moore, David Shaffer
OBJECTIVE: With improvements in medical management and survival of patients with end-stage renal disease, maintaining durable vascular access is increasingly challenging. This study compared primary, assisted primary, and secondary patency, and procedure-specific complications, and evaluated whether the number of interventions to maintain or restore patency differed between prosthetic femoral-femoral looped inguinal access (thigh) grafts and Hemodialysis Reliable Outflow (HeRO; Hemosphere Inc, Minneapolis, Minn) grafts...
July 18, 2016: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/27386452/upper-arm-basilic-vein-transposition-for-hemodialysis-a-single-center-study-for-300-cases
#15
Yunhee Lee, Dan Song, Myung Jin Kim, Sang Chul Yun
PURPOSE: The population of end-stage renal failure patients dependent on hemodialysis continues to expand with an increasing number of patients having an unsuitable cephalic vein or failed radio- and brachio-cephalic fistula. In these patients, the transposed basilic vein to brachial artery arteriovenous fistula (BaVT) provides autologous choice for hemodialysis. The results of basilic vein transposition arteriovenous fistula were assessed. MATERIALS AND METHODS: Three hundred cases of BaVT performed at a single center during the period of January 2005 to December 2011 were reviewed retrospectively...
June 2016: Vascular Specialist International
https://www.readbyqxmd.com/read/27377897/incidences-of-acute-kidney-injury-dialysis-and-graft-loss-following-intravenous-administration-of-low-osmolality-iodinated-contrast-in-patients-with-kidney-transplants
#16
Ghaneh Fananapazir, Christoph Troppmann, Michael T Corwin, Arian M Nikpour, Sima Naderi, Ramit Lamba
PURPOSE: To determine the incidence of acute kidney injury (AKI), need for emergent dialysis, and renal graft loss in patients with kidney transplants, who underwent CT examinations with low-osmolality iodine-based contrast material (IBCM). MATERIALS AND METHODS: Our institutional review board approved this retrospective Health Insurance Portability and Accountability Act compliant study. From January 2005 to April 2015, a total of 224 CT examinations were performed using low-osmolality IBCM in patients with kidney transplants...
July 5, 2016: Abdominal Radiology
https://www.readbyqxmd.com/read/27136475/use-of-preoperative-embolization-prior-to-transplant-nephrectomy
#17
Carrie Yeast, Julie M Riley, Joshua Holyoak, Gilbert Ross, Stephen Weinstein, Mark Wakefield
INTRODUCTION: After a failed transplant, management of a non-functional graft with pain or recurrent infections can be challenging. Transplant nephrectomy (TN) can be a morbid procedure with the potential for significant blood loss. Embolization of the renal artery alone has been proposed as a method of reducing complications from an in vivo failed kidney transplant. While this does yield less morbidity, it may not address an infected graft or refractory hematuria or rejection. We elected to begin preoperative embolization to assess if this would help decrease the blood loss and transfusion rate associated with TN...
January 2016: International Braz J Urol: Official Journal of the Brazilian Society of Urology
https://www.readbyqxmd.com/read/27048230/kidney-retransplantation-in-children-following-rejection-and-recurrent-disease
#18
Rebecca C Graves, Richard N Fine
Retransplantation accounts for approximately 15 % of the annual transplants performed in the USA, and in the recent International Collaborative Transplant Study report on pediatric patients 15.2 % of the 9209 patients included in the report were retransplant recipients. Although the significant advances in clinical management and newer immunosuppressive agents have had a significant impact on improving short-term allograft function, it is apparent that long-term allograft function remains suboptimal. Therefore, it is likely that the majority of pediatric renal allograft recipients will require one or more retransplants during their lifetime...
April 5, 2016: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
https://www.readbyqxmd.com/read/27043407/rituximab-for-recurrence-of-primary-focal-segmental-glomerulosclerosis-after-kidney-transplantation-clinical-outcomes
#19
Cyril Garrouste, Guillaume Canaud, Mathias Büchler, Joseph Rivalan, Charlotte Colosio, Frank Martinez, Julien Aniort, Caroline Dudreuilh, Bruno Pereira, Sophie Caillard, Carole Philipponnet, Dany Anglicheau, Anne Elisabeth Heng
BACKGROUND: Rituximab has shown encouraging results for the treatment of kidney transplantation recipients with focal segmental glomerulosclerosis (FSGS) recurrence. However, the correct, opportune, and safe use of rituximab for this indication remains to be determined. METHODS: This multicenter retrospective study reports on 19 new cases aged 35 (15-66) years who developed FSGS recurrence at 12 (1.5-27) days posttransplantation. Initial treatment consisted of plasma exchanges (PE), high doses of calcineurin inhibitors, and steroids...
April 13, 2016: Transplantation
https://www.readbyqxmd.com/read/27012124/-dialysis-reinitiation-after-kidney-transplant-failure-and-preparation-for-retransplantation
#20
REVIEW
Paweł Wróbel, Władysław Sułowicz
With the development of kidney transplantation procedure the number of patients returning to dialysis after losing their graft function is gradually increasing. Early return to dialysis after an unsuccessful kidney transplantation is associated with a worse prognosis. Patients with end stage transplanted kidney failure may be qualified again for the treatment of both peritoneal dialysis or hemodialysis. They represent an increased risk of complications as compared to patients without a history of previous kidney transplantation because they usually have high commorbidity, receive immunosuppressive therapy and during re-qualification to dialysis usually have no efficient vascular access or peritoneal catheter implanted...
2015: Przegla̧d Lekarski
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