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https://www.readbyqxmd.com/read/28643056/deep-neuromuscular-blockade-improves-surgical-conditions-during-low-pressure-pneumoperitoneum-laparoscopic-donor-nephrectomy
#1
D M D Özdemir-van Brunschot, A E Braat, M F P van der Jagt, G J Scheffer, C H Martini, J F Langenhuijsen, R E Dam, V A Huurman, D Lam, F C d'Ancona, A Dahan, M C Warlé
BACKGROUND: Evidence indicates that low-pressure pneumoperitoneum (PNP) reduces postoperative pain and analgesic consumption. A lower insufflation pressure may hamper visibility and working space. The aim of the study is to investigate whether deep neuromuscular blockade (NMB) improves surgical conditions during low-pressure PNP. METHODS: This study was a blinded randomized controlled multicenter trial. 34 kidney donors scheduled for laparoscopic donor nephrectomy randomly received low-pressure PNP (6 mmHg) with either deep (PTC 1-5) or moderate NMB (TOF 0-1)...
June 22, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28642820/intratumorally-injected-pro-inflammatory-allogeneic-dendritic-cells-as-immune-enhancers-a-first-in-human-study-in-unfavourable-risk-patients-with-metastatic-renal-cell-carcinoma
#2
Anna Laurell, Maria Lönnemark, Einar Brekkan, Anders Magnusson, Anna Tolf, Anna Carin Wallgren, Bengt Andersson, Lars Adamson, Rolf Kiessling, Alex Karlsson-Parra
BACKGROUND: Accumulating pre-clinical data indicate that the efficient induction of antigen-specific cytotoxic CD8+ T cells characterizing viral infections is caused by cross-priming where initially infected DCs produce an unique set of inflammatory factors that recruit and activate non-infected bystander DCs. Our DC-based immunotherapy concept is guided by such bystander view and accordingly, we have developed a cellular adjuvant consisting of pre-activated allogeneic DCs producing high levels of DC-recruiting and DC-activating factors...
2017: Journal for Immunotherapy of Cancer
https://www.readbyqxmd.com/read/28642453/cystatin-c-based-equation-does-not-accurately-estimate-the-glomerular-filtration-in-japanese-living-kidney-donors
#3
Kazuma Tsujimura, Morihito Ota, Kiyoshi Chinen, Takayuki Adachi, Kiyomitsu Nagayama, Masato Oroku, Morikuni Nishihira, Yoshiki Shiohira, Kunitoshi Iseki, Hideki Ishida, Kazunari Tanabe
BACKGROUND Precise evaluation of a living donor's renal function is necessary to ensure adequate residual kidney function after donor nephrectomy. Our aim was to evaluate the feasibility of estimating glomerular filtration rate (GFR) using serum cystatin-C prior to kidney transplantation. MATERIAL AND METHODS Using the equations of the Japanese Society of Nephrology, we calculated the GFR using serum creatinine (eGFRcre) and cystatin C levels (eGFRcys) for 83 living kidney donors evaluated between March 2010 and March 2016...
June 23, 2017: Annals of Transplantation: Quarterly of the Polish Transplantation Society
https://www.readbyqxmd.com/read/28640530/how-does-age-affect-the-outcome-of-kidney-transplantation-in-elderly-recipients
#4
Flavia Neri, Lucrezia Furian, Francesco Cavallin, Matteo Ravaioli, Cristina Silvestre, Paola Donato, Gaetano La Manna, Antonio Daniele Pinna, Paolo Rigotti
The aging of the on-dialysis population raises the issue of whether to propose elderly patients for kidney transplantation and how to manage their immunosuppression. This study aims to analyze the outcome of kidney transplantation on an Italian series of elderly recipients. We included in this retrospective study all patients over 60 years, receiving a deceased-donor kidney transplantation from January 2004 to December 2014 in two north Italian Centers. We analyzed the correlation of recipient age with graft's and patient's survival, delayed graft function (DGF), acute cellular rejection (ACR), surgical complications, infections and glomerular filtration rate (GFR)...
June 22, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/28640070/early-outcomes-of-the-new-uk-deceased-donor-kidney-fast-track-offering-scheme
#5
Chris J Callaghan, Lisa Mumford, Laura Pankhurst, Richard J Baker, J Andrew Bradley, Christopher J E Watson
BACKGROUND: The UK Kidney Fast-Track Scheme (KFTS) was introduced in 2012 to identify kidneys at high risk of discard and to rapidly facilitate transplantation. A retrospective analysis of kidneys transplanted through the KFTS was undertaken. METHODS: UK Transplant Registry data were collected on deceased donor kidneys implanted between 1 November 2012 and 30 April 2015 (DBD donors) and 1 March 2013 and 30 April 2015 (DCD donors). Posttransplant outcomes included 1-year eGFR and death-censored graft survival (DCGS)...
June 21, 2017: Transplantation
https://www.readbyqxmd.com/read/28640022/brain-dead-donors-on-extracorporeal-membrane-oxygenation
#6
Régis Bronchard, Louise Durand, Camille Legeai, Johana Cohen, Patrice Guerrini, Olivier Bastien
OBJECTIVES: To describe donors after brain death with ongoing extracorporeal membrane oxygenation and to analyze the outcome of organs transplanted from these donors. DESIGN: Retrospective analysis of the national information system run by the French Biomedicine Agency (CRISTAL database). SETTING: National registry data of all donors after brain death in France and their organ recipients between 2007 and 2013. PATIENTS: Donors after brain death and their organ recipients...
June 21, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28640014/potential-impact-of-risk-and-loss-aversion-on-the-process-of-accepting-kidneys-for-transplantation
#7
Raymond L Heilman, Ellen P Green, Kunam S Reddy, Adyr Moss, Bruce Kaplan
Behavioral economic theory suggests that people make decisions based on maximizing perceived value; however, this may be influenced more by the risk of loss rather than of potential gain. Additionally, individuals may seek certainty over uncertainty. These are termed loss aversion and risk aversion, respectively. Loss aversion is particularly sensitive to how the decision is "framed." Thus, labeling a kidney as high Kidney Donor Profile Index results in higher discard rates because this creates a nonlinearity in perceived risk...
July 2017: Transplantation
https://www.readbyqxmd.com/read/28639460/role-of-ct-scan-in-diagnosis-of-renal-lymphangiectasia-our-single-center-experience
#8
Vaidehi K Pandya, Harsh C Sutariya, Shruti P Gandhi, Sajni I Khemchandani, Himanshu V Patel, Maulin K Shah
BACKGROUND: Renal lymphangiectasia is rarely reported benign renal disorder of lymphatic malformation. Though found incidentally; it presents with nonspecific symptoms and shows characteristic findings in radiological imaging studies. AIM: Here, we report eight patients with symptoms, laboratory and imaging findings compatible with renal lymphangiectasia. This report describes clinical and laboratory characteristics, treatment, Imaging findings and outcome of a series of patients with renal lymphangiectasia and reviews the literature...
November 2017: Renal Failure
https://www.readbyqxmd.com/read/28639386/development-of-immune-response-to-tissue-restricted-self-antigens-in-simultaneous-kidney-pancreas-transplant-recipients-with-acute-rejection
#9
Muthukumar Gunasekaran, Neeta Vachharajani, Joseph P Gaut, Thin Thin Maw, Rowena Delos Santos, Surendra Shenoy, William C Chapman, Jason Wellen, Thalachallour Mohanakumar
Simultaneous kidney-pancreas transplantation (SKP Tx) is a treatment for end-stage kidney disease secondary to diabetes mellitus. We investigated the role of immune responses to donor human leukocyte antigens (HLA) and tissue-restricted kidney and pancreas self-antigens (KSAgs and PSAgs, respectively) in SKP Tx recipients (SKP TxRs). Sera collected from 39 SKP TxRs were used to determine de novo Abs specific for KSAgs (collagen-IV, Col-IV; fibronectin, FN) and PSAgs (insulin, islet cells, glutamic acid decarboxylase, and pancreas-associated protein-1) by ELISA...
June 21, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/28638611/does-size-matter-kidney-transplant-donor-size-determines-kidney-function-among-living-donors
#10
Meenakshi Narasimhamurthy, Lachlan M Smith, Jason T Machan, Steven E Reinert, Reginald Y Gohh, Lance D Dworkin, Basma Merhi, Nikunjkumar Patel, Michael D Beland, Susie L Hu
BACKGROUND: Kidney donor outcomes are gaining attention, particularly as donor eligibility criteria continue to expand. Kidney size, a useful predictor of recipient kidney function, also likely correlates with donor outcomes. Although donor evaluation includes donor kidney size measurements, the association between kidney size and outcomes are poorly defined. METHODS: We examined the relationship between kidney size (body surface area-adjusted total volume, cortical volume and length) and renal outcomes (post-operative recovery and longer-term kidney function) among 85 kidney donors using general linear models and time-to-chronic kidney disease data...
February 2017: Clinical Kidney Journal
https://www.readbyqxmd.com/read/28638610/looking-for-the-needle-in-the-kidney-transplantation-haystack
#11
Josep M Cruzado, Edoardo Melilli
The diagnosis of acute rejection still relies on renal allograft biopsy. In fact, histological features including C4d staining can be useful to differentiate cellular and antibody-mediated acute rejection. However, the pathogenic mechanism to define the type of rejection is usually assessed by anti-HLA donor specific antibodies (DSA) monitoring. Suspicion of acute rejection is usually based on renal function deterioration. This method has low sensitivity. Moreover, creatinine increase follows graft injury and therefore the diagnosis is performed when there is an ongoing acute rejection...
February 2017: Clinical Kidney Journal
https://www.readbyqxmd.com/read/28637095/selective-cd28-blockade-results-in-superior-inhibition-of-donor-specific-t-follicular-helper-cell-and-antibody-responses-relative-to-ctla-4-ig
#12
I R Badell, G M La Muraglia, D Liu, M E Wagener, G Ding, M L Ford
Donor-specific antibodies (DSA) are a barrier to improved long-term outcomes following kidney transplantation. Costimulation blockade with CTLA-4-Ig has shown promise as a potential therapeutic strategy to control DSA. T follicular helper (Tfh) cells, a subset of CD4(+) T cells required for optimum antibody production, are reliant on the CD28 costimulatory pathway. We have previously shown that selective CD28 blockade leads to superior allograft survival through improved control of CD8(+) T cells relative to CTLA-4-Ig, but the impact of CD28-specific blockade on CD4(+) Tfh cells is unknown...
June 21, 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/28637093/intra-abdominal-cooling-system-limits-ischemia-reperfusion-injury-during-robot-assisted-renal-transplantation
#13
Raphael P H Meier, Vincent Piller, Monika E Hagen, Charles Joliat, Jean-Bernard Buchs, Antonio Nastasi, Raphael Ruttimann, Nicolas C Buchs, Solange Moll, Jean-Paul Vallée, François Lazeyras, Philippe Morel, Leo Bühler
Robot-assisted kidney transplantation is feasible; however, concerns have been raised about possible increases in warm ischemia times. We describe a novel intra-abdominal cooling system to continuously cool the kidney during the procedure. Porcine kidneys were procured by standard open technique. Groups were as follow: Robotic renal transplantation with (n=11) and without (n=6) continuous intra-abdominal cooling and conventional open technique with intermittent 4°C saline cooling (n=6). Renal cortex temperature, magnetic resonance imaging and histology were analyzed...
June 21, 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/28636137/the-experience-of-waiting-for-a-kidney-transplant-a-qualitative-study
#14
Tania Burns, Ritin Fernandez, Moira Stephens
BACKGROUND: In Australia over 1100 people are living on dialysis while waiting for a kidney transplant from a deceased donor. Worldwide there are an estimated 170,000 people who wait an average of three years before an organ becomes available. OBJECTIVE: To provide an understanding of the lived experience of people waiting on dialysis for a kidney transplant from a deceased donor. APPROACH: A qualitative descriptive research design was used...
June 21, 2017: Journal of Renal Care
https://www.readbyqxmd.com/read/28636074/optimizing-outcomes-in-pancreas-transplantation-impact-of-organ-preservation-time
#15
Ehren N Rudolph, Ty B Dunn, David E R Sutherland, Raja Kandaswamy, Erik B Finger
Recent changes to pancreas graft allocation policy have increased the number of organs available for regional and distant sharing, which results in a corresponding increase in preservation time. We sought to systematically assess the impact of cold ischemia time (CIT) on outcomes posttransplant. A retrospective review of 1,253 pancreas transplants performed at a single transplant center was performed to correlate CIT to transplant outcomes. The rate of technical failure (TF) increased with 20+ hours of CIT, with a 2...
June 21, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/28634839/outcomes-of-kidney-donors-over-60%C3%A2-years-old-a-single-center-cohort-study
#16
Daniel Gero, Fadia Dib, Maurice Matter, Manuel Pascual, Jean-Pierre Venetz, Nicolas Demartines, Emmanuel Melloul
AIM: To evaluate outcomes and post-donation kidney function of older living kidney donors (LKD). METHODS: Retrospective analysis of prospective database including all consecutive LKD undergoing laparoscopic nephrectomy in a single center (09/1998-12/2013). LKD aged ≥60 years were compared to younger LKD. Renal function assessed by creatinine levels and estimated glomerular filtration rates (eGFR). Surgical complications classified according to the Clavien-Dindo classification...
June 20, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28634772/the-effect-of-desensitization-therapy-in-kidney-transplantation
#17
Yong Chul Kim, Mi-Yeon Yu, Jung Pyo Lee, Hajeong Lee, Sang-Il Min, Jongwon Ha, Yon Su Kim
BACKGROUND: Desensitization therapy may enable the patient to get allograft in sensitized recipient or solve the organ shortage in ABO-incompatible relationship in kidney transplantation (KT). However, the graft outcome and morbidity remains unclear. METHODS: We retrospectively analyzed 845 KT patients from January 2010 to February 2016 at Seoul National University Hospital. The patients were divided into three groups as follows: HLA-incompatible (HLAi) group, ABO-incompatible (ABOi) group, and control group...
June 20, 2017: Clinical and Experimental Nephrology
https://www.readbyqxmd.com/read/28632265/3d-printed-conformal-microfluidics-for-isolation-and-profiling-of-biomarkers-from-whole-organs
#18
Manjot Singh, Yuxin Tong, Kelly Webster, Ellen Cesewski, Alexander P Haring, Sahil Laheri, Bill Carswell, Timothy J O'Brien, Charles H Aardema, Ryan S Senger, John L Robertson, Blake N Johnson
The ability to interface microfluidic devices with native complex biological architectures, such as whole organs, has the potential to shift the paradigm for the study and analysis of biological tissue. Here, we show 3D printing can be used to fabricate bio-inspired conformal microfluidic devices that directly interface with the surface of whole organs. Structured-light scanning techniques enabled the 3D topographical matching of microfluidic device geometry to porcine kidney anatomy. Our studies show molecular species are spontaneously transferred from the organ cortex to the conformal microfluidic device in the presence of fluid flow through the organ-conforming microchannel...
June 20, 2017: Lab on a Chip
https://www.readbyqxmd.com/read/28631900/-experimental-development-and-rationale-for-a-renal-decellularization-protocol-with-subsequent-comprehensive-assessment-of-the-biological-scaffold
#19
P V Glybochko, S N Alekseenko, E A Gubareva, E V Kuevda, A A Basov, A S Sotnichenko, S S Dzhimak, I S Gumenyuk, I Kh Egiev, V N Chechelyan, R Z Nakokhov, O M Lyasota, Yu V Teterin
Chronic renal failure (CRF) is one of the most challenging problems of contemporary medicine. Patients with chronic renal failure usually need renal replacement therapy as either hemodialysis, peritoneal dialysis or a kidney transplant. The latter is the most promising option for end-stage kidney disease. However, the shortage of donor organs, the complexity of their delivery, the difficulty in finding an immunologically compatible donor and the need for lifelong immunosuppression triggered advances in modern tissue engineering...
June 2017: Urologii︠a︡
https://www.readbyqxmd.com/read/28629951/immunogenicity-of-class-i-hla-but-not-preformed-low-mfi-donor-specific-antibodies-correlates-with-outcomes-after-first-renal-transplantation
#20
A Lobashevsky, W Goggins, K Rosner, T Taber
BACKGROUND: The role of low levels of circulating donor specific antibodies (DSA) producing negative flow cytometry cross match is not completely defined. The purpose of this study was to examine the clinical significance of preexisting low levels of class I DSAs in flow cytometry cross match (FC CM) negative first kidney transplant recipients (KTRs). METHODS: All of the KTRs (n=41) had low levels of anti-class I antibodies only. The kidney transplant outcome was evaluated by the development of a deleterious effect (DE) in recipients in the study cohort (Group 1: DE+, Group 2: DE-)...
June 16, 2017: Transplant Immunology
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