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Living donor kidney

Damien C O'Neill, Niall F Davis, Timothy É Murray, Michael J Lee, Dilly Little, Martina M Morrin
OBJECTIVES: Prospective renal donors are a select population of healthy individuals who have been thoroughly screened for significant comorbidities before they undergo multidetector computed tomography. Our aim was to determine the prevalence of incidental findings on preoperative multidetector computed tomography in a healthy cohort of potential living donors for kidney transplant. MATERIALS AND METHODS: A prospective study was performed of prospective living kidney transplant donors at a national kidney transplant center...
August 17, 2018: Experimental and Clinical Transplantation
Andriy V Trailin, Tamara N Nykonenko, Tetyana I Ostapenko, Sergiy R Vildanov, Olexandr S Nykonenko
OBJECTIVES: Our aim was to evaluate which histologic lesions in a donor kidney were associated with graft function up to 5 years and with its dynamics. MATERIALS AND METHODS: We retrospectively investigated the association between acute and chronic individual histologic lesions and composite scores in preimplant and postreperfusion biopsies from deceased-donor (n = 101) and living-donor (n = 29) kidneys with initial graft function and function at discharge, at 6 months, and at 5 years and slopes of estimated glomerular filtration rate from discharge to 6 months and from 6 months to 5 years...
August 17, 2018: Experimental and Clinical Transplantation
Milton Halyson Benevides de Freitas, Luciana Cavalcanti Lima, Tania Cursino de Menezes Couceiro, Wilton Bernadino da Silva, João Marcelo de Andrade, Marcio Handerson Benevides de Freitas
INTRODUCTION: Successful renal transplant and consequent good graft function depend on a good surgical technique, an anesthetic that ensures the hemodynamic stability of the receiver, and appropriate conditions of graft and recipient. Several factors can interfere with the perfusion of the graft and compromise its viability. The objective of this study was to evaluate perioperative factors associated with delayed graft function (DGF) in renal transplantation patients. METHODS: This is a historical cohort study of patients who underwent renal transplantation between 2011 and 2013...
August 13, 2018: Jornal Brasileiro de Nefrologia: ʹorgão Oficial de Sociedades Brasileira e Latino-Americana de Nefrologia
Natesan Anand Vijai, Palanisamy Senthilnathan, Vikram Annamaneni, Sandeep C Sabnis, Arvinder Singh Soin, Chinnusamy Palanivelu
Liver transplantation is a ray of hope for thousands of patients with end-stage liver disease but is currently challenged by the scarcity of donor organs worldwide. Unlike kidney transplantation where minimally invasive donor organ procurement has almost become a norm, laparoscopic procurement of hemi-liver from a living donor is still in the infancy of development, at least in the Indian sub-continent. Minimally invasive surgery has made its way into different procedures of hepatobiliary and pancreatic surgery, but only a few centres in the world are performing pure laparoscopic donor hepatectomy...
August 7, 2018: Journal of Minimal Access Surgery
Tapas Kumar Singh, Sandeep Sahu, Anil Agarwal, Devendra Gupta, Prabhaker Mishra
Background and Aims: Catheter-related bladder discomfort (CRBD) has started to gain recognition as a problem in early postoperative care. Dexmedetomidine reduces bladder contractility via M3 muscarinic receptor antagonism and α-2 receptor agonism, apart from its concomitant therapeutic benefits, such as sedation and sympatholysis, in a postoperative period. We, therefore, evaluated the efficacy of dexmedetomidine in reducing incidence and severity of CRBD. Material and Methods: This prospective, randomized, double-blind, placebo-controlled trial done on 110 voluntary kidney donors for live related kidney transplantations were planned for laparoscopic donor nephrectomy...
April 2018: Journal of Anaesthesiology, Clinical Pharmacology
Jennifer C Gander, Xingyu Zhang, Laura Plantinga, Sudeshna Paul, Mohua Basu, Stephen O Pastan, Eric Gibney, Erica Hartmann, Laura Mulloy, Carlos Zayas, Rachel E Patzer
BACKGROUND: Racial disparities persist in access to kidney transplantation. Racial differences in preemptive referral, or referral prior to dialysis start, may explain this discrepancy. METHODS: Patient-level data on kidney transplant referrals (2005-2012) from all Georgia transplant centers were linked to the United States Renal Data System to examine racial disparities in preemptive referral, waitlisting, and living donor transplant. Adjusted logistic regression and Cox proportional hazard models determined the associations between race (African American vs...
August 12, 2018: Clinical Transplantation
Graziano Vignolini, Francesco Sessa, Isabella Greco, Alessandro Pili, Saverio Giancane, Arcangelo Sebastianelli, Giampaolo Siena, Mauro Gacci, Vincenzo Li Marzi, Riccardo Campi, Sergio Serni
Background: Autosomal dominant polycystic kidney disease (ADPKD) is a common cause of end-stage renal disease (ESRD) and may pose significant technical challenges for kidney transplantation. Recently, robot-assisted kidney transplantation (RAKT) has been shown to achieve excellent patient and graft outcomes while reducing surgical morbidity. However, the vast majority of RAKT performed so far were from living donors and no studies reported the outcomes of RAKT in patients with ADPKD. Case Presentation: Herein, we describe the first successful case of RAKT from a brain-dead deceased donor in a 37-year-old patient with ESRD due to ADPKD...
2018: Journal of Endourology Case Reports
Eric P Zhou, Elizabeth Kiwanuka, Paul E Morrissey
Background: The Internet has extensive resources for kidney transplantation recipients. Half of the population reads below a seventh-grade level. Previous studies showed that living donor recipients have higher health literacy rates compared with deceased donor recipients. There has been no study comparing the readability of online living donor recipient materials versus deceased donor recipient materials. Methods: Analysis was performed using eight readability scales on the top 10 websites for live donor and deceased donor kidney transplantation...
August 2018: Clinical Kidney Journal
Wida S Cherikh, Linda C Cendales, Christopher L Wholley, Jennifer Wainright, Vijay S Gorantla, David K Klassen, Sue McDiarmid, L Scott Levin
On July 3, 2014, the Organ Procurement and Transplantation Network/United Network for Organ Sharing was charged with the oversight of Vascularized Composite Allograft (VCA) procurement and transplantation in the U.S. As of December 31, 2017, 61 VCA programs at 27 centers were approved in the U.S. Fifty candidates have been added to the waiting list at 15 centers. Twenty-eight VCA transplants have been performed at 14 programs (10 upper limb, 10 uterus, 5 craniofacial, 1 scalp, 1 abdominal wall, and 1 penile)...
August 9, 2018: American Journal of Transplantation
Marco van Londen, Nicolien Kasper, Niek R Hessels, A Lianne Messchendorp, Stephan J L Bakker, Jan-Stephan F Sanders, Stefan P Berger, Martin H de Borst, Gerjan Navis
Compensatory GFR increase after kidney donation results in a GFR above 50% of the pre-donation value. The Renal Functional Reserve assessed by the renal response to dopamine infusion (RFRdopa ) is considered to reflect functional reserve capacity and thought to be a tool for living donor screening. However, it is unknown if the RFRdopa predicts long-term kidney function. Between 1984 and 2017, we prospectively measured mGFR (125- I-Iothalamate) and RFR by dopamine infusion in 937 living kidney donors. We performed linear regression analysis of pre-donation RFRdopa and post-donation GFR...
August 8, 2018: American Journal of Physiology. Renal Physiology
Claire Kennedy, Limy Wong, Donal J Sexton, Jonathan Cowman, Irene Oglesby, Martin Kenny, Peter J Conlon, Dermot Kenny
Background: Uraemic platelet dysfunction is not completely understood, in part due to non-physiological platelet function assays. We have developed a physiological flow-based assay that quantifies platelet function in microlitre volumes of blood under arterial shear. The aim of this study was to characterize platelet function before and after kidney transplantation. Methods: Ten patients scheduled for living donor kidney transplant surgery and nine healthy controls were analysed using the assay...
August 2018: Clinical Kidney Journal
Courtenay M Holscher, Tanveen Ishaque, Jacqueline M Garonzik Wang, Christine E Haugen, Sandra R DiBrito, Kyle Jackson, Abimereki D Muzaale, Allan B Massie, Fawaz Al Ammary, Shane E Ottman, Macey L Henderson, Dorry L Segev
Development of ESRD in living kidney donors is associated with increased graft loss in the recipients of their kidneys. Our goal was to investigate if this relationship was reflected at an earlier stage post-donation, possibly early enough for recipient risk prediction based on donor response to nephrectomy. Using national registry data, we studied 29,464 recipients and their donors from 2008-2016 to determine the association between donor 6-month post-nephrectomy eGFR and recipient death-censored graft failure (DCGF)...
August 7, 2018: American Journal of Transplantation
Emrullah Söğütdelen, Tolga Yildirim, Hakan Bahadir Haberal, Uğur Canpolat, Tuncay Hazirolan, Hasan Serkan Doğan, Şeref Rahmi Yilmaz, Yunus Erdem, Fazil Tuncay Aki
OBJECTIVES: Our goal was to determine the short-term effects of donor nephrectomy on the cardiovascular system and to gain a better understanding of the recently recognized long-term increased risk of end-stage renal disease and cardiovascular mortality. MATERIALS AND METHODS: Living kidney donors who underwent donor nephrectomy between January 2010 and January 2015 at the Hacettepe University Transplantation Unit were retrospectively screened. Echocardiographic parameters, kidney volumes, and renal functions before nephrectomy were compared with measurements after nephrectomy...
August 6, 2018: Experimental and Clinical Transplantation
Ngan N Lam, Krista L Lentine, Brenda Hemmelgarn, Scott Klarenbach, Robert R Quinn, Anita Lloyd, Sita Gourishankar, Amit X Garg
Background: Previous guidelines recommend that living kidney donors receive lifelong annual follow-up care to assess renal health. Objective: To determine whether these best practice recommendations are currently being followed. Design: Retrospective cohort study using linked health care databases. Setting: Alberta, Canada (2002-2014). Patients: Living kidney donors. Measurements: We determined the proportion of donors who had annual outpatient physician visits and laboratory measurements for serum creatinine and albuminuria...
2018: Canadian Journal of Kidney Health and Disease
Amit X Garg
The best treatment option for many patients with kidney failure is a kidney transplant from a living donor. Countries that successfully increase their rate of living kidney donation will decrease their reliance on dialysis, the most expensive and high-risk form of kidney replacement therapy. Outlined here are some barriers that prevent some patients from pursuing living kidney donation and current knowledge on some potential solutions to these barriers. Also described are strategies to promote living kidney donation in a defensible system of practice...
August 6, 2018: Clinical Journal of the American Society of Nephrology: CJASN
Donald C Dafoe, Ekamol Tantisattamo, Uttam Reddy
Successful renal transplantation is a highly effective endeavor that improves and prolongs the lives of patients with chronic kidney disease. Transplant surgery and immunosuppression carries risk and the demand for donor kidneys outstrips supply by far. These realities mandate thoughtful allocation and utilization of this limited resource to select candidates. As the criteria for candidates and donor grafts continue to expand, the field must adapt and seek new approaches. The complex process-from evaluation of candidates, transplant surgery, immunosuppression, and follow-up care after transplantation-is, of necessity, tightly structured and regulated...
July 2018: Seminars in Nephrology
Jinhae Kim, Jeeeun Park, Subin Hwang, Heejin Yoo, Kyunga Kim, Jae Berm Park, Hye Ryoun Jang, Jung Eun Lee, Sung-Joo Kim, Yoon-Goo Kim, Dae Joong Kim, Ha Young Oh, Wooseong Huh
Although various strategies for steroid withdrawal after transplantation have been attempted, there are few reports of the long-term results of steroid withdrawal regimens in kidney transplantation. Earlier, we reported on a 5-year prospective, randomized, single-center trial comparing the safety and efficacy of cyclosporine (CsA) plus mycophenolate mofetil (MMF) with that of tacrolimus (TAC) plus MMF, when steroids were withdrawn 6 months after kidney transplantation in low-risk patients. We now report the 10-year observational data on the study population...
August 6, 2018: Clinical Transplantation
Kenice Ferguson-Paul, Catherine Park, Sandra Childress, Sandra Arnold, Bettina Ault, Bindiya Bagga
BACKGROUND: We report a case series of histoplasmosis in KTx patients in a children's hospital in an endemic area. METHODS: All KTx cases from January 1, 2002, to August 31, 2016, were reviewed to identify those with disseminated histoplasmosis. RESULTS: The attack rate of histoplasmosis among our KTx patients was 6.9 per 100 cases. The median age at the time of diagnosis was 16 years (11-18). Comorbidities included glomerulosclerosis (3), medullary cystic disease (1), and obstructive uropathy (2) and HIV (1)...
August 3, 2018: Pediatric Transplantation
Sarah E Van Pilsum Rasmussen, Mary Grace Bowring, Ashton A Shaffer, Macey L Henderson, Allan Massie, Aaron A R Tobian, Dorry L Segev, Christine M Durand
BACKGROUND: HIV+ donor organs can now be transplanted into HIV+ recipients (HIV D+/R+) following the HIV Organ Policy Equity (HOPE) Act. Implementation of the HOPE Act requires transplant center awareness and support of HIV D+/R+ transplants. METHODS: To assess center-level barriers to implementation, we surveyed 209 transplant centers on knowledge, attitudes, and planned HIV D+/R+ protocols. RESULTS: Responding centers (n=114; 56%) represented all UNOS regions...
August 3, 2018: Clinical Transplantation
K Weigand
Organ donation has reached a new low in Germany. The number of organ donations dropped from 1296 in 2010 to just 797 organ donations in 2017. This represents a decrease of 916 kidney transplants in the last six years. Thus, Germany occupies the penultimate position in the Eurotransplant association with the number of organ donors per million inhabitants. Only Luxembourg has fewer because of foreigners proportion of 47.5% and many of them lives in the neighboring european countries. However, Germany is not only far behind in the Eurotransplant association with the number of organ donors, but Germany is also at the bottom in comparison with other European countries with comparable political, ethical, religious and social structures-are we so different from our European neighbors? Germany is a country with one of the best health care systems in the world, but not in the field of organ donation...
August 2, 2018: Der Urologe. Ausg. A
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