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https://www.readbyqxmd.com/read/28805990/absence-of-jc-polyomavirus-jcpyv-in-early-post-transplant-jcpyv-nephropathy-a-case-report
#1
Chitimaporn Janphram, Suchin Worawichawong, Sinee Disthabanchong, Vasant Sumethkul, Porpon Rotjanapan
JC polyomavirus (JCPyV)-associated nephropathy (JCPyVAN) occurs in < 3% of PVAN cases after renal transplantation. We report the first confirmed case to our knowledge of JCPyVAN diagnosed by kidney biopsy in the early 6 months post transplant in Thailand. In this case report, recovery of renal allograft function was not observed after reduction of immunosuppressive agents and administration of intravenous immunoglobulin and cidofovir. Despite persistent JCPyV viruria, no significant further decline in allograft function was documented at 15 months post transplant...
August 14, 2017: Transplant Infectious Disease: An Official Journal of the Transplantation Society
https://www.readbyqxmd.com/read/28805345/laparoscopic-sleeve-gastrectomy-improves-renal-transplant-candidacy-and-post-transplant-outcomes-in-morbidly-obese-patients
#2
Y Kim, A D Jung, V K Dhar, J S Tadros, D P Schauer, E P Smith, D J Hanseman, M C Cuffy, R R Alloway, A R Shields, S A Shah, E S Woodle, T S Diwan
Morbid obesity is a barrier to KT due to inferior outcomes, including higher rates of new-onset diabetes after transplantation (NODAT), delayed graft function (DGF), and graft failure. LSG increases transplant eligibility by reducing body mass index (BMI) in KT candidates, but the effect of surgical weight loss on post-transplant outcomes is unknown. Reviewing single-center medical records, we identified all patients who underwent LSG prior to KT from 2011-2016 (n=20). Post-LSG kidney recipients were compared with similar-BMI recipients who did not undergo LSG, using 2:1 direct matching for patient factors...
August 14, 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/28805266/hypothermic-pulsatile-preservation-of-kidneys-from-uncontrolled-deceased-donors-after-cardiac-arrest
#3
Xavier Matillon, Fabrice Danjou, Palmina Petruzzo, Olivier Thaunat, Thomas Rimmele, Claire Delsuc, Alexandre Faure, Maud Rabeyrin, Vannary Meas Yedid, William Hanf, Emmanuel Morelon, Lionel Badet, Ricardo Codas
Kidneys from uncontrolled donors after cardiac arrest (uDCD) suffer from a period of warm ischemia between cardiac arrest and cold flushing. Aim of the study was to evaluate renal outcomes of uDCD kidneys selected on the basis of renal Resistance Index (RI) and its influence on graft function and survival. The study included 44 kidneys procured from 26 uDCD starting 1.1.2006 until 31.12.2013. The donors (Maastricht category II) underwent cardiopulmonary resuscitation by assisted ventilation and chest compression; the organs were preserved with "in situ" cold perfusion or a normothermic regional perfusion...
August 14, 2017: Transplant International: Official Journal of the European Society for Organ Transplantation
https://www.readbyqxmd.com/read/28805142/intravenous-immunoglobulins-modify-relapsing-membranous-glomerulonephritis-after-kidney-transplantation-a-case-report
#4
Sanne Steyaert, Jo Van Dorpe, Anne Hoorens, Wim Van Biesen, Steven Van Laecke
OBJECTIVES: Recurrence of membranous glomerulonephritis after transplant is common and is an important cause of loss of renal graft. This case supports the effect of immunoglobulins in the treatment of this disease after transplantation. It is the first report in the literature with a follow-up of more than 10 years and because of the sustained effect of the immunoglobulins, it strengthens the idea that this can alter long-term outcome. METHODS: Single case study and search of the literature...
August 14, 2017: Acta Clinica Belgica
https://www.readbyqxmd.com/read/28803679/systematic-review-of-the-methods-predictive-of-the-functionality-of-kidney-transplantation
#5
E Miret Alomar, E Trilla Herrera, D Lorente Garcia, L Regis Placido, R López Del Campo, M Cuadras Solé, T Pont Castellana, F Moreso Mateos, D Serón Micas, J Morote Robles
CONTEXT: Kidney transplantation from donors with expanded criteria has increased the pool of kidneys at the cost of a higher risk of short and long-term graft dysfunction. The main issue lies in determining which kidneys will offer acceptable function and survival compared with the risk represented by surgery and subsequent immunosuppression. OBJECTIVE: The objective of our article is to review the current evidence on the tools for predicting the functionality of kidney transplantation from cadaveric donors with expanded criteria and determining the validity for their use in standard practice...
August 10, 2017: Actas Urologicas Españolas
https://www.readbyqxmd.com/read/28802764/factors-influencing-renal-graft-survival-7-year-experience-of-a-single-center
#6
Rūta Auglienė, Eglė Dalinkevičienė, Vytautas Kuzminskis, Mindaugas Jievaltas, Laima Peleckaitė, Agnė Gryguc, Edgaras Stankevičius, Inga Arūnė Bumblytė
BACKGROUND AND OBJECTIVE: The demand for kidney transplants exceeds the existing supply. This leads to a recently growing interest of research in the area of factors that could prolong graft long-term outcomes and survival. In Lithuania, approximately 90% of kidney transplantations are from deceased donors. Donor organs are received and shared only inside the country territory in Lithuania; therefore, donor data is accurate and precise. This study was performed to present particularities of kidney transplantation data in Lithuania and to identify the effect of donor and recipient factors and histologic findings on renal graft outcomes...
July 29, 2017: Medicina
https://www.readbyqxmd.com/read/28801959/outcomes-of-patients-with-atypical-hemolytic-uremic-syndrome-with-native-and-transplanted-kidneys-treated-with-eculizumab-a-pooled-post-hoc-analysis
#7
Christophe M Legendre, Josep M Campistol, Thorsten Feldkamp, Giuseppe Remuzzi, John F Kincaid, Åsa Lommelé, Jimmy Wang, Laurent E Weekers, Neil S Sheerin
Atypical hemolytic uremic syndrome (aHUS) often leads to end-stage renal disease (ESRD) and kidney transplantation; graft loss rates are high due to disease recurrence. A post hoc analysis of four prospective clinical trials in aHUS was performed to evaluate eculizumab, a terminal complement inhibitor, in patients with native or transplanted kidneys. The trials included 26-week treatment and extension periods. Dialysis, transplant, and graft loss were evaluated. Study endpoints included complete thrombotic microangiopathy (TMA) response, TMA event-free status, hematologic and renal parameters, and adverse events...
August 12, 2017: Transplant International: Official Journal of the European Society for Organ Transplantation
https://www.readbyqxmd.com/read/28801294/-early-intervention-of-bk-virus-replication-promotes-stabilization-of-renal-graft-function
#8
Wei-Ming Deng, Yan-Na Liu, Li-Xin Yu, Wen-Feng Deng, Shao-Jie Fu, Jian Xu, Chuan-Fu DU, Yi-Bin Wang, Ru-Min Liu, Gui-Rong Ye, Gang Huang, Yun Miao
OBJECTIVE: To investigate the optimal time window for intervention of BK virus (BKV) replication and its effect on the outcomes of kidney transplant recipients (KTRs). METHODS: A retrospective analysis of the clinical data and treatment regimens was conducted among KTRs whose urine BKV load was ≥1.0×10(4) copies/mL following the operation between April, 2000 and April, 2015. KTRs with urine BKV load <1.0×10(4) copies/mL matched for transplantation time served as the control group...
August 20, 2017: Nan Fang Yi Ke da Xue Xue Bao, Journal of Southern Medical University
https://www.readbyqxmd.com/read/28799839/renal-outcome-after-kidney-transplantation-in-korean-patients-with-lupus-nephritis
#9
E S Park, S S Ahn, S M Jung, J J Song, Y-B Park, S-W Lee
We investigated renal outcome of kidney-transplantation in 19 Korean recipients with biopsy-proven lupus nephritis and compared it with 18 Korean age- and gender-matched recipients without lupus nephritis who were diagnosed with end-stage renal disease caused by renal diseases other than lupus nephritis in a single centre. We reviewed histological findings of kidneys and calculated cumulative dose of immunosuppressive agents. We assessed renal flare of systemic lupus erythematosus, recurrence of lupus nephritis and graft failure as prognosis...
January 1, 2017: Lupus
https://www.readbyqxmd.com/read/28799694/patient-with-a-total-artificial-heart-maintained-on-outpatient-dialysis-while-listed-for-combined-organ-transplant-a-single-center-experience
#10
Ramy M Hanna, Huma Hasnain, Mohammad Kamgar, Mina Hanna, Raffi Minasian, James Wilson
Advanced mechanical circulatory support is increasingly being used with more sophisticated devices that can deliver pulsatile rather than continuous flow. These devices are more portable as well, allowing patients to await cardiac transplantation in an outpatient setting. It is known that patients with renal failure are at increased risk for developing worsening acute kidney injury during implantation of a ventricular assist device (VAD) or more advanced modalities like a total artificial heart (TAH). Dealing with patients who have an implanted TAH who develop renal failure has been a challenge with the majority of such patients having to await a combined cardiac and renal transplant prior to transition to outpatient care...
August 11, 2017: Hemodialysis International
https://www.readbyqxmd.com/read/28798825/ex-vivo-ureteroscopy-of-deceased-donor-kidneys
#11
Graham L Machen, Preston A Milburn, Patrick S Lowry, Jacqueline A Lappin, Debra K Doherty, Marawan M El Tayeb
INTRODUCTION: When encountered, the ideal management of lithiasis in deceased donor kidneys is not well-defined. With advances in endourological techniques, minimally invasive treatments are becoming an increasingly viable option. We set out to describe our experience performing ex-vivo ureteroscopy on cadaveric donor kidneys, including one in which the procedure was completed on-pump. METHODS: A retrospective chart review was undertaken to identify patients who had undergone ex-vivo ureteroscopy prior to cadaveric renal transplant...
August 2017: Canadian Urological Association Journal, Journal de L'Association des Urologues du Canada
https://www.readbyqxmd.com/read/28795324/the-fgf23-klotho-axis-and-cardiac-tissue-doppler-imaging-in-pediatric-chronic-kidney-disease-a-prospective-cohort-study
#12
Ylva Tranæus Lindblad, Hannes Olauson, Georgios Vavilis, Ulf Hammar, Maria Herthelius, Jonas Axelsson, Peter Bárány
BACKGROUND: Chronic kidney disease-associated mineral bone disorder (CKD-MBD) is common in pediatric kidney disease patients and a risk factor for future cardiovascular disease (CVD). Fibroblast growth factor-23 (FGF23) and Klotho are novel key players in CKD-MBD, and has been suggested to be involved in the development of CVD. METHODS: This prospective cohort study included 74 pediatric patients; 31 with CKD (age range 0.8-18.8 years, glomerular filtration rate (GFR) range 9-68 mL/min/1...
August 9, 2017: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
https://www.readbyqxmd.com/read/28795151/kidney-transplantation-in-patients-with-active-multiple-myeloma-case-reports
#13
Erik Lawrence Lum, Neil Kogut, Thu Pham, Gabriel M Danovitch, Suphamai Bunnapradist
Kidney disease is a common complication in patients with multiple myeloma. Traditionally, patients with active multiple myeloma and end-stage renal disease have been excluded from kidney transplantation due to the risk of malignancy progression. The introduction of bortezomib-based therapy for patients with multiple myeloma and renal impairment has significantly improved survival in this population. In this report, we present 2 cases of patients with active and controlled multiple myeloma who underwent successful kidney transplantation without progression of their underlying malignancy...
August 2017: Transplantation Direct
https://www.readbyqxmd.com/read/28795150/the-effects-of-tacrolimus-on-t-cell-proliferation-are-short-lived-a-pilot-analysis-of-immune-function-testing
#14
Benjamin L Laskin, Jing Jiao, H Jorge Baluarte, Sandra Amaral, Susan L Furth, Tatiana Akimova, Wayne W Hancock, Matthew H Levine, Peter P Reese, Ulf H Beier
BACKGROUND: Optimal immunosuppression after organ transplant should balance the risks of rejection, infection, and malignancy while minimizing barriers to adherence including frequent or time-sensitive dosing. There is currently no reliable immune function assay to directly measure the degree of immunosuppression after transplantation. METHODS: We developed an immune function assay to mea//sure T-cell proliferation after exposure to immunosuppression in vivo. We tested the assay in mice, and then piloted the approach using single time point samples, 11 pediatric kidney transplant recipients prescribed tacrolimus, mycophenolate, and prednisone 6 months to 5 years posttransplant, with no history of rejection, opportunistic infection, or cancer...
August 2017: Transplantation Direct
https://www.readbyqxmd.com/read/28795146/refining-the-policy-for-timing-of-kidney-transplant-waitlist-qualification
#15
Benjamin J Lee, Charles E McCulloch, Barbara A Grimes, Sindhu Chandran, Isabel Elaine Allen, Cynthia Delgado, Chi-Yuan Hsu
BACKGROUND: Earlier qualification for the kidney transplant waitlist expedites transplant and is therefore associated with improved outcomes. U.S. Organ Procurement and Transplantation Network policies state that "measured or calculated creatinine clearance or glomerular filtration rate less than or equal to 20 mL/min" triggers waitlist time accrual. The choice of qualification method is somewhat arbitrary, and the policy implies that decline in renal function is monotonic. METHODS: (1) We used survival analysis to quantify temporal differences in waitlist qualification by applying 3 kidney-function-estimating equations (Cockcroft-Gault, Modification of Diet in Renal Disease study, Chronic Kidney Disease Epidemiology Collaboration) to serial creatinine measurements from 3 patient cohorts: 1 of waitlisted patients at a major U...
August 2017: Transplantation Direct
https://www.readbyqxmd.com/read/28795144/renal-outcomes-in-patients-with-iga-nephropathy-undergoing-liver-transplant-a-retrospective-cohort-study
#16
Musab S Hommos, Ziad M El-Zoghby
BACKGROUND: End-stage liver disease (ESLD) is the most common cause of secondary immunoglobulin A nephropathy (IgAN). Multiple mechanisms have been proposed to explain the association between liver disease and IgAN. Although some mechanisms are expected to reverse in patients after liver transplant, the long-term renal prognosis is unclear for these patients. METHODS: This observational retrospective cohort study examined the renal outcomes of 14 patients who had IgAN with end-stage liver disease and subsequently underwent either liver transplant alone or combined liver and kidney transplant at a single tertiary care center...
August 2017: Transplantation Direct
https://www.readbyqxmd.com/read/28795143/high-intrapatient-variability-of-tacrolimus-levels-and-outpatient-clinic-nonattendance-are-associated-with-inferior-outcomes-in-renal-transplant-patients
#17
Dawn L Goodall, Michelle Willicombe, Adam G McLean, David Taube
BACKGROUND: Nonadherence to immunosuppressants is associated with rejection and allograft loss. Intrapatient variability (IPV) of immunosuppression levels is a marker of nonadherence. This study describes the impact of IPV of tacrolimus levels in patients receiving a tacrolimus monotherapy immunosuppression protocol. METHODS: We retrospectively analyzed the outpatient tacrolimus levels of kidney-only transplant patients taken between 6 and 12 months posttransplant...
August 2017: Transplantation Direct
https://www.readbyqxmd.com/read/28795142/plasma-proenkephalin-and-poor-long-term-outcome-in-renal-transplant-recipients
#18
Lyanne M Kieneker, Oliver Hartmann, Joachim Struck, Andreas Bergmann, Ron T Gansevoort, Michel M Joosten, Else van den Berg, Rudolf A de Boer, Stephan J L Bakker
BACKGROUND: Proenkephalin (pro-ENK), a stable and reliable surrogate marker for unstable enkephalins, was found to be associated with acute kidney injury and chronic renal failure in previous studies. We aimed to investigate whether pro-ENK is linked to chronic kidney injury and poor long-term outcome in renal transplant recipients (RTR). METHODS: We included 664 stable RTR and 95 healthy kidney donors. Pro-ENK was measured in plasma with a double monoclonal sandwich immunoassay...
August 2017: Transplantation Direct
https://www.readbyqxmd.com/read/28795141/posttransplant-outcomes-of-kidneys-donated-after-brain-death-followed-by-circulatory-death-a-cohort-study-of-128-chinese-patients
#19
Ning Na, Ke Li, Zhengyu Huang, Bin Miao, Cheng Hu, Heng Li, Dejuan Wang, Jianguang Qiu
BACKGROUND: Donation after brain death followed by circulatory death (DBCD) is a new class in the unique Chinese donor classification system. Currently, in China, the organ transplantation of DBCD is rising. However, there is a dearth of research on the characteristics and outcomes of DBCD kidney transplantation. METHOD: We collected 128 DBCD renal transplant patients who underwent surgery between June 2013 and May 2016 at our center to analyze clinical outcomes and to share our experience to enhance perioperative management in DBCD kidney transplantation...
August 2017: Transplantation Direct
https://www.readbyqxmd.com/read/28795136/renal-autotransplantation-and-extracorporeal-nephron-sparing-surgery-for-de-novo-renal-cell-carcinoma-in-a-kidney-allograft
#20
Shinichiro Ono, Takashi Kenmochi, Taihei Ito, Naohiro Aida, Kazunori Otsuki, Naotake Akutsu, Michihiro Maruyama, Mamoru Kusaka, Ryoichi Shiroki, Kiyotaka Hoshinaga
De novo renal cell carcinoma (RCC) rarely occurs in kidney allografts; however, the risk of RCC in these patients is 100-fold that of the general healthy population. Although total nephrectomy has been the standard treatment for kidney allograft RCC, several authors have reported that early-stage RCC in kidney allografts was successfully treated with nephron-sparing surgery. We herein describe a new procedure involving renal autotransplantation and extracorporeal nephron-sparing surgery, which was performed to treat de novo RCC near the hilum of a transplanted kidney...
August 2017: Transplantation Direct
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