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https://www.readbyqxmd.com/read/28810723/graft-survival-of-pediatric-kidney-transplant-recipients-selected-for-de-novo-steroid-avoidance-a-propensity-score-matched-study
#1
Edward J Nehus, Chunyan Liu, Bo Lu, Maurizio Macaluso, Mi-Ok Kim
Background: Steroid-avoidance protocols have gained popularity in pediatric kidney transplant recipients at low immunologic risk. The long-term safety of steroid avoidance in children with immunologic risk factors remains unknown. Methods: Pediatric kidney transplant recipients from 2004 to 2014 in the Organ Procurement and Transplantation Network database who received tacrolimus and mycophenolate immunosuppression were investigated. Propensity score matching was used to compare graft survival in 1624 children who received steroid avoidance with 1624 children who received steroid-based immunosuppression...
August 1, 2017: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/28805300/the-kidney-allocation-system-does-not-appropriately-stratify-risk-of-pediatric-donor-kidneys-implications-for-pediatric-recipients
#2
S M Nazarian, A W Peng, B Duggirala, M Gupta, T Bittermann, S Amaral, M H Levine
Kidney Allocation System (KAS) was enacted in 2014 to improve graft utility, while facilitating transplantation of highly-sensitized patients and preserving pediatric access to high-quality kidneys. Central to this system is the Kidney Donor Profile Index (KDPI), a metric intended to predict transplant outcomes based on donor characteristics but derived using only adult donors. We posited that KAS had inadvertently altered the profile and quantity of kidneys made available to pediatric recipients. This question arose from our observation that most pediatric donors carry a KDPI over 35 and have therefore been rendered relatively inaccessible to pediatric recipients under KAS...
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/28804573/changing-landscape-of-hepatitis-c-virus-positive-donors
#4
Catherine E Kling, Ajit P Limaye, Lena Sibulesky
With the introduction of the new highly effective antiviral therapies, there has been a dramatic increase in the use of the hepatitis C virus (HCV)-positive livers in HCV-positive recipients. In the majority of studies, HCV positivity was defined as a donor testing HCV Ab positive. In 2015, all Organ Procurement Organizations were mandated to perform and report HCV Nucleic Acid Amplification Testing (NAT) results on all deceased and living donors. Studies are not yet available on how organs are being utilized based on NAT status and whether NAT status affects recipient outcomes...
July 18, 2017: World Journal of Hepatology
https://www.readbyqxmd.com/read/28802764/factors-influencing-renal-graft-survival-7-year-experience-of-a-single-center
#5
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/28798825/ex-vivo-ureteroscopy-of-deceased-donor-kidneys
#6
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/28796849/neutrophil-extracellular-traps-and-fibrin-in-otitis-media-analysis-of-human-and-chinchilla-temporal-bones
#7
Patricia A Schachern, Geeyoun Kwon, David E Briles, Patricia Ferrieri, Steven Juhn, Sebahattin Cureoglu, Michael M Paparella, Vladimir Tsuprun
Background: Bacterial resistance in acute otitis can result in bacterial persistence and biofilm formation, triggering chronic and recurrent infections. Objective: To investigate the middle ear inflammatory response to bacterial infection in human and chinchilla temporal bones. Design, Setting, and Participants: Six chinchillas underwent intrabullar inoculations with 0.5 mL of 106 colony-forming units (CFUs) of Streptococcus pneumoniae, serotype 2...
August 10, 2017: JAMA Otolaryngology—Head & Neck Surgery
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
#8
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/28795019/safe-and-ethical-living-kidney-donation-in-qatar-a-national-health-system-s-approach
#9
Muhammad Asim, Yousuf Al-Maslamani, Hassan Al-Malki
The increasing incidence of end-stage kidney disease in Qatar has led to growing demand for donor kidneys. The deceased donor kidney program has yet to achieve its full potential; hence, living kidney donation has been widely adopted as an appropriate alternative. The reliance on living kidney donors however, raises a number of social, ethical, and legal concerns surrounding informed consent, voluntarism, psychosocial evaluation, perioperative care, and long-term follow-up of living kidney donors. Many of these concerns become heightened in a multicultural, multilingual society within a Gulf country such as Qatar...
2017: Qatar Medical Journal
https://www.readbyqxmd.com/read/28777478/a-simplified-method-of-calculating-cpra-for-kidney-allocation-application-in-hong-kong
#10
Yuen Piu Chan, Monica Wing Kan Wong, Lydia Wing Mui Tang, Mengbiao Guo, Wanling Yang, Patrick Ip, Philip Kam Tao Li, Chi Bon Leung, Ka Foon Chau, Johnny Chi Kwong Lam, Nicholas Ka Ming Yeung, Janette Siu Yin Kwok
Calculated panel reactive antibody (cPRA) represents possibility of encountering an incompatible donor for organ transplant candidates, and has gradually replaced traditional PRA as a measurement of sensitization level. We tested two cPRA calculation methods on a cohort of renal candidate (n=613). HLA typing of 563 Chinese deceased renal donors were used to estimate allele and haplotype frequencies of Hong Kong donor pool. The OPTN formula was adopted to generate cPRA (cPRA(freq)). We also incorporated a computer script to compare unacceptable antigens of patients against HLA phenotype of donors...
August 4, 2017: Transplant International: Official Journal of the European Society for Organ Transplantation
https://www.readbyqxmd.com/read/28776960/role-of-de-novo-donor-specific-anti-hla-antibodies-in-kidney-graft-failure-a-case-control-study
#11
Ana Castro, Jorge Malheiro, Sandra Tafulo, Leonídio Dias, La Salete Martins, Isabel Fonseca, Idalina Beirão, António Castro-Henriques, António Cabrita
The role of de novo donor-specific anti-HLA antibodies (dnDSA) within the pathways leading to graft failure remains not fully understood. We investigated 56 patients who were transplanted between 2002-2014 with kidney graft failure (cases), for a possible association of development of dnDSA with graft failure. The 56 patients with failed transplants were matched with 56 patients with a functioning graft at present for the variables deceased or living donor, transplant number, transplant year, recipient age and gender, donor age and gender, dialysis vintage time, transplant induction therapy...
August 4, 2017: HLA
https://www.readbyqxmd.com/read/28774486/histopathology-of-tympanic-membranes-from-patients-with-ventilation-tubes
#12
Mehmet Faruk Oktay, Hasan Deniz Tansuker, Hisaki Fukushima, Michael M Paparella, Patricia A Schachern, Sebahattin Cureoglu
OBJECTIVE: To evaluate the histopathologic changes in tympanic membranes (TMs) with ventilation tubes (VTs). METHODS: In this retrospective human temporal bone study our overall study group included 4 subgroups of TMs from deceased donors as follows: 24 with a history of VT insertion for chronic otitis media with effusion (COME-VT); 5 with a history of VT insertion for Meniere's disease (MD-VT); 33 without a history of VT insertion for chronic otitis media with effusion (COME); and 14 without a history of VT insertion for Meniere's disease (MD)...
July 31, 2017: Auris, Nasus, Larynx
https://www.readbyqxmd.com/read/28771117/trends-in-deceased-donor-kidney-availability-and-utilization-in-the-kingdom-of-saudi-arabia
#13
Fayez Hejaili, Besher Attar, Faissal A M Shaheen
OBJECTIVES: We investigated trends in deceased donor kidney availability and utilization in Saudi Arabia, wait list changes, and recipient characteristics. MATERIALS AND METHODS: Ten-year registry data from the Saudi Center for Organ Transplantation were analyzed, including consent/discard rates, numbers of kidneys from deceased donors versus expanded criteria and standard criteria donors, wait list characteristics, dialysis characteristics, and causes of chronic kidney disease...
August 2017: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/28767141/are-transplant-recipients-human-subjects-when-research-is-conducted-on-organ-donors
#14
Kate Gallin Heffernan, Alexandra K Glazier
Interventional research on deceased organ donors and donor organs prior to transplant holds the promise of reducing the number of patients who die waiting for an organ by expanding the pool of transplantable organs and improving transplant outcomes. However, one of the key challenges researchers face is an assumption that someone who receives an organ that was part of an interventional research protocol is always a human subject of that same study. The consequences of this assumption include the need for oversight by an institutional review board and for research-level informed consent from transplant recipients, all within the complex practical realities of the organ donation and transplantation process in the United States...
August 2, 2017: Hastings Center Report
https://www.readbyqxmd.com/read/28766066/outcome-of-kidney-transplantation-in-pediatric-patients-with-anca-associated-glomerulonephritis-a-single-center-experience
#15
Damien Noone, Rae S M Yeung, Diane Hebert
OBJECTIVES: Data on kidney transplant outcomes for pediatric patients with end-stage renal disease (ESRD) secondary to anti-neutrophil cytoplasmic antibody glomerulonephritis (ANCA GN), particularly granulomatosis with polyangiitis (GPA) and microscopic polyangiitis (MPA), is limited. We describe our experience of kidney transplantation in pediatric ANCA GN patients. METHODS: We performed a retrospective review of patients with ANCA GN who developed ESRD and were transplanted at a single center between the years 2000 and 2014...
August 1, 2017: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
https://www.readbyqxmd.com/read/28758329/kidney-allograft-offers-predictors-of-turndown-and-the-impact-of-late-organ-acceptance-on-allograft-survival
#16
J B Cohen, J Shults, D S Goldberg, P L Abt, D L Sawinski, P P Reese
There is growing interest in understanding patterns of organ acceptance and reducing discard. Little is known about how donor factors, timing of procurement, and geographic location affect organ offer decisions. We performed a retrospective cohort study of 47,563 deceased donor kidney match-runs from 2007-2013. Several characteristics unrelated to allograft quality were independently associated with later acceptance in the match-run: Public Health Service increased-risk donor status (adjusted odds ratio [aOR] 2...
July 31, 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/28753247/take-away-body-parts-an-investigation-into-the-use-of-3d-printed-anatomical-models-in-undergraduate-anatomy-education
#17
Claire F Smith, Nicholas Tollemache, Derek Covill, Malcolm Johnston
Understanding the three-dimensional (3D) nature of the human form is imperative for effective medical practice and the emergence of 3D printing creates numerous opportunities to enhance aspects of medical and healthcare training. A recently deceased, un-embalmed donor was scanned through high-resolution computed tomography. The scan data underwent segmentation and post-processing and a range of 3D-printed anatomical models were produced. A four-stage mixed-methods study was conducted to evaluate the educational value of the models in a medical program...
July 28, 2017: Anatomical Sciences Education
https://www.readbyqxmd.com/read/28751632/extracorporeal-membrane-oxygenation-support-for-rituximab-induced-acute-respiratory-distress-syndrome-in-an-abo-incompatible-living-donor-liver-transplant-recipient-successful-management-of-a-rare-complication-and-a-review-of-the-literature
#18
Ping-Chun Li, Ashok Thorat, Shih-Chao Hsu, Kin-Shing Poon, Horng-Ren Yang, Te-Hung Chen, Chun-Chieh Yeh, Long-Bin Jeng
BACKGROUND Rituximab is commonly used to reduce the agglutinin titer in ABO-incompatible liver transplant recipients. Although well-tolerated, rituximab infusion therapy may result in severe pulmonary adverse effects such as drug-induced pneumonitis, leading to acute respiratory distress syndrome (ARDS), which has a high mortality rate. Management of such rare cases in an ABO-incompatible patient has never been described before. Herein, we present successful use of extracorporeal membrane oxygenation (ECMO) support for rituximab-induced ARDS in an ABO-incompatible living donor liver transplantation (LDLT) recipient...
July 28, 2017: Annals of Transplantation: Quarterly of the Polish Transplantation Society
https://www.readbyqxmd.com/read/28751578/achieving-equity-through-reducing-variability-in-accepting-deceased-donor-kidney-offers
#19
EDITORIAL
Sumit Mohan, Mariana C Chiles
No abstract text is available yet for this article.
July 27, 2017: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/28751577/outcomes-of-deceased-donor-kidney-offers-to-patients-at-the-top-of-the-waiting-list
#20
Anne M Huml, Jeffrey M Albert, J Daryl Thornton, Ashwini R Sehgal
BACKGROUND AND OBJECTIVES: Transplant centers may accept or refuse deceased-donor kidneys that are offered to their patients at the top of the waiting list. We sought to determine the outcomes of deceased-donor kidney offers and their association with characteristics of waitlisted patients and organ donors. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: We examined all 7 million deceased-donor adult kidney offers in the United States from 2007 to 2012 that led to eventual transplantation...
July 27, 2017: Clinical Journal of the American Society of Nephrology: CJASN
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