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https://www.readbyqxmd.com/read/29349948/case-report-of-kidney-paired-donation-kpd-with-desensitization-the-strategy-and-experience-of-3-way-kpd-in-samsung-medical-center
#1
Dongkyu Oh, Eun Suk Kang, Shinae Yu, Kyoungsuk Chun, Wooseong Huh, Hye Ryoun Jang, Chan Woo Cho, Nuri Lee, Kyo Won Lee, Hyojun Park, Jae Berm Park, Sung Joo Kim
As the need for the organ donation increases, strategies to increase kidney transplantation (KT) through expanded living donation have become essential. These include kidney paired donation (KPD) programs and desensitization in incompatible transplantations. KPD enables kidney transplant candidates with incompatible living donors to join a registry with other incompatible pairs in order to find potentially compatible living donor. Positive cross match and ABO incompatible transplantation has been successfully accomplished in selective cases with several pre-conditionings...
January 29, 2018: Journal of Korean Medical Science
https://www.readbyqxmd.com/read/29349580/perianesthetic-management-of-laparoscopic-kidney-surgery
#2
REVIEW
Georges Nasrallah, Fouad G Souki
PURPOSE OF REVIEW: Laparoscopic kidney surgery is commonly used for living donor, partial, and total tumor nephrectomy. The successful emergence of laparoscopic technique was justified by the many benefits offered such as reduced blood loss, tissue trauma, pain, and hospital stay. However, this comes at the expense of physiologic changes and complications secondary to pneumoperitoneum, surgical technique, and patient positioning with significant challenges in anesthetic management. RECENT FINDINGS: A variety of laparoscopic approaches (transperitoneal, retroperitoneal, hand-assisted, robotic) are used with some having advantages over others...
January 18, 2018: Current Urology Reports
https://www.readbyqxmd.com/read/29346260/race-risk-and-willingness-of-end-stage-renal-disease-patients-without-hepatitis-c-hcv-to-accept-an-hcv-infected-kidney-transplant
#3
Maureen McCauley, Adam Mussell, David Goldberg, Deirdre Sawinski, Rodolfo N Molina, Ricarda Tomlin, Sahil D Doshi, Peter Abt, Roy Bloom, Emily Blumberg, Sanjay Kulkarni, Gabriela Esnaola, Justine Shults, Carrie Thiessen, Peter P Reese
BACKGROUND: Despite effective antiviral treatment, hundreds of kidneys from deceased donors with hepatitis C virus (HCV) are discarded annually. Little is known about the determinants of willingness to accept HCV-infected kidneys among HCV-negative patients. METHODS: At 2 centers, 189 patients undergoing initial or reevaluation for transplant made 12 hypothetical decisions about accepting HCV-infected kidneys in which we systematically varied expected HCV cure rate, allograft quality and wait-time for an uninfected kidney...
January 18, 2018: Transplantation
https://www.readbyqxmd.com/read/29346257/association-of-cold-ischemia-time-with-acute-renal-transplant-rejection
#4
Merve Postalcioglu, Arnaud D Kaze, Benjamin C Byun, Andrew Siedlecki, Stefan G Tullius, Edgar L Milford, Julie M Paik, Reza Abdi
BACKGROUND: Kidney transplantation holds much promise as a treatment of choice for patients with end stage kidney disease. The impact of cold ischemia time (CIT) on acute renal transplant rejection (ARTR) remains to be fully studied in a large cohort of renal transplant patients. METHODS: From the Organ Procurement and Transplantation Network database, we analyzed 63,798 deceased donor renal transplants performed between 2000-2010. We assessed the association between CIT and ARTR...
January 18, 2018: Transplantation
https://www.readbyqxmd.com/read/29346254/long-term-outcomes-of-pediatric-en-bloc-kidney-transplantation-a-single-center-experience-with-25-years-follow-up
#5
Kalathil K Sureshkumar, Amr Habbach, Amy Tang, Bhavna Chopra
BACKGROUND: Pediatric en bloc kidneys are considered marginal for transplantation into adults. We aimed to compare the long-term outcomes of pediatric en bloc vs. living donor kidney transplantation. METHODS: A retrospective review was undertaken on pediatric en bloc and living donor kidney transplants performed at our center between 1990 and 2001. The outcomes compared between the groups included 25 year graft survival and longitudinal glomerular filtration rate (GFR)...
January 18, 2018: Transplantation
https://www.readbyqxmd.com/read/29345387/fortuitous-benefits-of-living-kidney-donation-diagnosis-of-serious-medical-conditions-during-the-living-donor-evaluation
#6
Arika Hoffman, Ketki Tendulkar, Shaheed Merani, Alexander Maskin, Alan Langnas
BACKGROUND: All living kidney donors are counseled about the possible surgical and medical risks associated with donation. Only a minority of transplant centers discuss the potential benefit of discovering undiagnosed medical conditions in the donor during evaluation, as part of their consent process. METHODS: We retrospectively investigated all potential living kidney donors evaluated over a 10-year period at a single center to characterize incidentally diagnosed serious medical conditions...
January 18, 2018: Clinical Transplantation
https://www.readbyqxmd.com/read/29343314/cell-free-dna-the-role-in-pathophysiology-and-as-a-biomarker-in-kidney-diseases
#7
Peter Celec, Barbora Vlková, Lucia Lauková, Janka Bábíčková, Peter Boor
Cell-free DNA (cfDNA) is present in various body fluids and originates mostly from blood cells. In specific conditions, circulating cfDNA might be derived from tumours, donor organs after transplantation or from the foetus during pregnancy. The analysis of cfDNA is mainly used for genetic analyses of the source tissue -tumour, foetus or for the early detection of graft rejection. It might serve also as a nonspecific biomarker of tissue damage in critical care medicine. In kidney diseases, cfDNA increases during haemodialysis and indicates cell damage...
January 18, 2018: Expert Reviews in Molecular Medicine
https://www.readbyqxmd.com/read/29343027/-using-creatinine-reduction-ratio-as-a-predictor-for-delayed-graft-function-of-kindey-transplant-recipients-from-donor-of-cardiac-death
#8
Z J Sun, X D Zhang, L Ren, X Y Yang, J F Cai, X Li, X Zheng, W Wang
Objective: To explore the relationship between creatinine reduction ratio (CRR) and delayed graft function among kidney transplant recipients from donor of cardiac death (DCD). To define the value of CRR to predict delayed graft function (DGF) in early post-transplant period. Method: 86 patients were included, who received renal transplantation from DCD during Jan 1(st) 2011 to Jun 30(th) 2016. We performed a retrospective study and collected creatinine data within 3 days post-operation and marked them with Cr1, Cr2 , Cr3, and then calculated creatinine reduction ratio day-2 (CRR 2) =(Cr1-Cr2)/Cr1×100% and creatinine reduction ratio day-3 (CRR 3)=[(Cr1-Cr2)/Cr1+ (Cr2-Cr3)/Cr2]/2×100%...
January 2, 2018: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/29341388/venous-anastomosis-by-piggyback-technique-to-avoid-twisting-of-the-pediatric-en-bloc-kidney-grafts
#9
Jun Li, Raphael Schild, Jochen Herrmann, Jun Oh, Lutz Fischer, Martina Koch
This is the first report of using piggyback technique for the venous anastomosis in two pediatric recipients of small en bloc kidneys, which was found to be effective to avoid twisting of the grafts and vessels. The donors were aged 2 and 3 years with a body weight of 17 and 20 kg. The recipient age was 14 and 16 years with a body weight of 42 and 54 kg. The implantation was done extraperitoneally in the right iliac fossa. The donor's inferior vena cava was anastomosed to the recipient's distal caval vein side-to-side using 6-0 polydioxanone running suture as the piggyback technique, initially dealing with the short vena cava graft in the first case...
January 16, 2018: Pediatric Transplantation
https://www.readbyqxmd.com/read/29339549/apol1-genotype-and-renal-function-of-black-living-donors
#10
Mona D Doshi, Mariella Ortigosa-Goggins, Amit X Garg, Lihua Li, Emilio D Poggio, Cheryl A Winkler, Jeffrey B Kopp
Black living kidney donors are at higher risk of developing kidney disease than white donors. We examined the effect of the APOL1 high-risk genotype on postdonation renal function in black living kidney donors and evaluated whether this genotype alters the association between donation and donor outcome. We grouped 136 black living kidney donors as APOL1 high-risk (two risk alleles; n=19; 14%) or low-risk (one or zero risk alleles; n=117; 86%) genotype. Predonation characteristics were similar between groups, except for lower mean±SD baseline eGFR (CKD-EPI equation) in donors with the APOL1 high-risk genotype (98±17 versus 108±20 ml/min per 1...
January 16, 2018: Journal of the American Society of Nephrology: JASN
https://www.readbyqxmd.com/read/29338381/effect-of-the-diabetic-state-on-islet-engraftment-and-function-in-a-large-animal-model-of-islet-kidney-transplantation
#11
Prashanth Vallabhajosyula, Atsushi Hirakata, Matthew Weiss, Adam Griesemer, Akira Shimizu, Hanzhou Hong, Andreas Habertheuer, Vaja Tchipashvili, Kazuhiko Yamada, David H Sachs
In islet transplantation, in addition to immunologic and ischemic factors, the diabetic/hyperglycemic state of the recipient has been proposed, although not yet validated, as a possible cause of islet toxicity, contributing to islet loss during the engraftment period. Using a miniature swine model of islet transplantation, we have now assessed the effect of a persistent state of hyperglycemia on islet engraftment and subsequent function. An islet-kidney (IK) model previously described by our laboratory was utilized...
November 2017: Cell Transplantation
https://www.readbyqxmd.com/read/29337451/-nephrology
#12
Sophie De Seigneux, Belen Ponte, Karine Hadaya, Yassine Bouatou, Patrick Saudan
New antidiabetic drugs which slow effectively the course of diabetic nephropathy are now available. There is no benefit of prophylactic hydratation to prevent contrast nephropathy in patients with moderate chronic kidney disease. In elderly hemodialysis patients, hemodiafiltration seems better tolerated than conventional hemodialysis, although there is a similar dialysis-induced myocardial stress with both methods. Role of de novo donor-specific antibodies is better characterized, which may subsequently lead to new treatments of graft rejection...
January 10, 2018: Revue Médicale Suisse
https://www.readbyqxmd.com/read/29336856/evaluation-of-kidney-donors-core-curriculum-2018
#13
Deirdre Sawinski, Jayme E Locke
Nearly 100,000 patients are waiting for a kidney transplant, yet each year only 11,000 undergo transplantation with a deceased donor kidney. Annual death rates among waitlist registrants range from 5% to 15%; many die before receiving a transplant. Not surprisingly, registrants turn to family and friends to become living kidney donors on their behalf. Living kidney donor selection practices aim to quantify lifetime risk for kidney failure based on a candidate's predonation demographic and health characteristics...
January 11, 2018: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/29334529/midterm-outcome-of-kidney-transplantation-from-donors-with-thin-basement-membrane-nephropathy
#14
Chanjoong Choi, Sanghyun Ahn, Seung-Kee Min, Jongwon Ha, Curie Ahn, Yonsu Kim, Hajeong Lee, Sang-Il Min
BACKGROUND: Thin basement membrane nephropathy (TBMN) is the most common cause of persistent glomerular hematuria. Most individuals with TBMN show a benign course, although it can be difficult to distinguish it from early stages of progressive renal diseases. However, only limited studies address the prognosis of donors with TBMN and their recipients. METHODS: From 2007 to 2016, 11 recipients received kidney grafts from donors with TBMN, and their clinical data were analyzed retrospectively...
January 12, 2018: Transplantation
https://www.readbyqxmd.com/read/29333639/decreasing-deceased-donor-transplant-rates-among-children-%C3%A2-6-years-under-the-new-kidney-allocation-system
#15
Brittany A Shelton, Deirdre Sawinski, Christopher Ray, Rhiannon D Reed, Paul A MacLennan, Justin Blackburn, Carlton J Young, Stephen Gray, Megan Yanik, Allan Massie, Dorry L Segev, Jayme E Locke
The Kidney Allocation System (KAS) was implemented in December 2014 with unknown impact on the pediatric waitlist. To understand the effect of KAS on pediatric registrants, deceased donor kidney transplant (DDKT) rate was assessed using interrupted time series analysis and time-to-event analysis. Two allocation eras were defined with an intermediary washout period: Era 1 (01/01/2013-09/01/2014), Era 2 (09/01/2014-03/01/2015), and Era 3(03/01/2015-03/01/2017). When using Cox proportional hazards, there was no significant association between allocation era and DDKT likelihood as compared to Era 1 (Era 3: aHR: 1...
January 15, 2018: American Journal of Transplantation
https://www.readbyqxmd.com/read/29332204/supplementing-living-kidney-transplantees-medical-records-with-donor-and-recipient-narratives
#16
Anne Hambro Alnæs
Norway provides total social welfare coverage for organ transplantations, including free immunosuppressive medication and prepaid life-long follow up for both recipients and donors. Despite these benefits the proportion of living kidney donors (LKD) has in recent years declined from around 40% (2011) of all kidney transplantations to 24% (2016). This study suggests harnessing patient- and donor-narratives as a tool for addressing the current fall in donation rates. The hospital records of 18 recipient/donor dyads were compared with patient and donor accounts elicited in semi-structured interviews...
January 13, 2018: Medicine, Health Care, and Philosophy
https://www.readbyqxmd.com/read/29331397/persistent-hyperparathyroidism-as-a-risk-factor-for-long-term-graft-failure-the-need-to-discuss-indication-for-parathyroidectomy
#17
Maria Júlia Correia Lima Nepomuceno Araujo, Janaina Almeida Mota Ramalho, Rosilene Motta Elias, Vanda Jorgetti, William Nahas, Melani Custodio, Rosa M A Moysés, Elias David-Neto
BACKGROUND: Although a successful kidney transplant (KTx) improves most of the mineral and bone disorders (MBD) produced by chronic kidney disease (CKD), hyperparathyroidism may persist (pHPT). Current guidelines recommend parathyroidectomy if serum parathormone is persistently elevated 1 year after KTx, because pHPT has been recently associated with poor graft outcomes. However, whether patients with pHPT and adequate renal function are at risk for long-term graft failure is unknown...
January 10, 2018: Surgery
https://www.readbyqxmd.com/read/29330339/hiv-positive-kidney-donor-selection-for-hiv-positive-transplant-recipients
#18
Elmi Muller, Zunaid Barday
The risks associated with transplanting HIV-positive kidneys into HIV-positive recipients have not been well studied. Since 2008, 43 kidneys from 25 HIV-positive deceased donors have been transplanted into patients who are HIV positive in Cape Town, South Africa. Among the donors, 19 (76%) died secondary to trauma. The average age for donors was 34 (interquartile range, 19-52) years old. In some donors, only one kidney was used because of a limited number of suitable recipients on the waiting list. Only two donors had been previously exposed to antiretroviral triple therapy...
January 12, 2018: Journal of the American Society of Nephrology: JASN
https://www.readbyqxmd.com/read/29330112/macrochimerism-and-clinical-transplant-tolerance
#19
REVIEW
John D Scandling, Stephan Busque, Robert Lowsky, Judith Shizuru, Asha Shori, Edgar Engleman, Kent Jensen, Samuel Strober
Current theory holds that macrochimerism is essential to the development of transplant tolerance. Hematopoietic cell transplantation from the solid organ donor is necessary to achieve macrochimerism. Over the last 10 to 20 years, trials of tolerance induction with combined kidney and hematopoietic cell transplantation have moved from the preclinical to the clinical arena. The achievement of macrochimerism in the clinical setting is challenging, and potentially toxic due to the conditioning regimen necessary to hematopoietic cell transplantation and due to the risk of graft-versus-host disease...
January 9, 2018: Human Immunology
https://www.readbyqxmd.com/read/29329489/mycophenolic-acid-and-its-metabolites-in-kidney-transplant-recipients-a-semimechanistic-enterohepatic-circulation-model-to-improve-estimating-exposure
#20
Malek Okour, Pamala A Jacobson, Mariam A Ahmed, Ajay K Israni, Richard C Brundage
Mycophenolic acid (MPA) is an approved immunosuppressive agent widely prescribed to prevent rejection after kidney transplantation. Wide between-subject variability (BSV) in MPA exposure exists which in part may be due to variability in enterohepatic recirculation (EHC). Several modeling strategies were developed to evaluate EHC as part of MPA pharmacokinetics, however mechanistic representation of EHC is limited. These models have not provided a satisfactory representation of the physiology of EHC in their modeling assumptions...
January 12, 2018: Journal of Clinical Pharmacology
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