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https://www.readbyqxmd.com/read/29471303/awareness-of-the-new-kidney-allocation-system-among-united-states-dialysis-providers-with-low-waitlisting
#1
Rachel E Patzer, Mohua Basu, Kayla D Smith, Laura Plantinga, Sumit Mohan, Cam Escoffery, Joyce J Kim, Taylor Melanson, Stephen O Pastan
It is unknown whether dialysis facility staff are aware of the new kidney allocation system implemented in December 2014, which changed how deceased donor kidneys are allocated and waiting time is calculated. U.S. dialysis facilities with low annual waitlisting (<15.2%) were surveyed as part of a large randomized study. Among 653 facilities, 57.9% of staff were aware of the policy change, with medical directors (84.4%) being more aware than social workers (73.3%), facility administrators (53.1%), nurse managers (46...
February 22, 2018: American Journal of Nephrology
https://www.readbyqxmd.com/read/29467993/pediatric-renal-transplantation-in-oman-a-single-center-experience
#2
Mohamed S Al Riyami, Sulaiman Al Saidi, Badria Al Ghaithi, Anisa Al Maskari, Sadiq Lala, Nabil Mohsin, Lekha Hirshikesan, Naifain Al Kalbani
Objectives: This study sought to report 22 years experience in pediatric kidney transplantation in Oman. Methods: Electronic charts of all Omani children below 13 years of age who received a kidney transplant from January 1994 to December 2015 were reviewed. Data collected included patient demographics, etiology of end-stage kidney disease, modality and duration of dialysis, donor type, complication of kidney transplantation (including surgical complications, infections, graft rejection) graft and patient survival, and duration of follow-up...
January 2018: Oman Medical Journal
https://www.readbyqxmd.com/read/29466849/predictors-of-postoperative-infectious-complications-in-liver-transplant-recipients-experience-of-185-consecutive-cases
#3
Seungjin Lim, Eun Jung Kim, Tae Beom Lee, Byung Hyun Choi, Young Mok Park, Kwangho Yang, Je Ho Ryu, Chong Woo Chu, Su Jin Lee
Background/Aims: Infections following liver transplant (LT) remain a major cause of mortality. This study was conducted to evaluate risk factors for infection and to review clinical characteristics. Methods: Medical records of patients who underwent LT from 2010 to 2014 were retrospectively analyzed. Binary logistic regression analysis was used to investigate risk factors of infection. Kaplan-Meier analysis was used to predict prognosis of infected and non-infected groups...
February 23, 2018: Korean Journal of Internal Medicine
https://www.readbyqxmd.com/read/29464832/differential-effects-of-donor-specific-hla-antibodies-in-living-versus-deceased-donor-transplantation
#4
E G Kamburova, B W Wisse, I Joosten, W A Allebes, A van der Meer, L B Hilbrands, M C Baas, E Spierings, C E Hack, F E van Reekum, A D van Zuilen, M C Verhaar, M L Bots, A C A D Drop, L Plaisier, M A J Seelen, J S F Sanders, B G Hepkema, A J Lambeck, L B Bungener, C Roozendaal, M G J Tilanus, C E Voorter, L Wieten, E M van Duijnhoven, M Gelens, M H L Christiaans, F J van Ittersum, S A Nurmohamed, N M Lardy, W Swelsen, K A van der Pant, N C van der Weerd, I J M Ten Berge, F J Bemelman, A Hoitsma, P J M van der Boog, J W de Fijter, M G H Betjes, S Heidt, D L Roelen, F H Claas, H G Otten
The presence of donor-specific anti-HLA antibodies (DSA) is associated with increased risk of graft failure after kidney transplantation. We hypothesized that DSA against HLA class-I, -II or both indicate a different risk for graft loss between deceased- and living-donor transplantation. In this study we investigated the impact of pretransplant DSA, assessed using single antigen bead assays, on long-term graft survival in 3237 deceased- and 1487 living-donor kidney transplantations with a negative complement-dependent crossmatch...
February 21, 2018: American Journal of Transplantation
https://www.readbyqxmd.com/read/29464204/tailored-rabbit-antithymocyte-globulin-induction-dosing-for-kidney-transplantation
#5
Namita Singh, Ana P Rossi, Marizela Savic, Ronald J Rubocki, Mark G Parker, John P Vella
Background: Rabbit antithymocyte globulin (rATG) is the most widely used kidney transplant induction immunotherapy in the United States. It was recently Food and Drug Administration approved for this indication with typical dose recommendations of 1.5 mg/kg for up to 7 days given via a central line. Methods: We theorized that reduced rATG dosing when compared with conventional dosing (6-10.5 mg/kg) is safe and effective, leading to development of a risk-stratified treatment protocol...
February 2018: Transplantation Direct
https://www.readbyqxmd.com/read/29463396/-renal-transplantation
#6
L Rostaing
Renal transplantation is the best option for patients with end stage renal failure, since it significantly improves their duration and quality of life. The number of patients waiting for a kidney transplant continues to increase while the overall rate of organ procurement in France is stable. The graft shortage is worsening, as is the waiting time on list. Identifying the causes of this crisis and discussing the various options for addressing the kidney graft shortage is the aim of this talk. Among the solutions: (i) improving identification of potential donors through a national and hospitals policy to promulgate organ donation and understanding better the grounds for refusal; (ii) using infusion machines for all grafts with extended criteria; (iii) developing transplantation programs from deceased donors after cardiac arrest; (iv) developing transplantation programs from living donors...
June 2017: Néphrologie & Thérapeutique
https://www.readbyqxmd.com/read/29462353/predicition-models-for-delayed-graft-function-external-validation-on-the-dutch-prospective-renal-transplantation-registry
#7
Jesper Kers, Hessel Peters-Sengers, Martin B A Heemskerk, Stefan P Berger, Michiel G H Betjes, Arjan D van Zuilen, Luuk B Hilbrands, Johan W de Fijter, Azam S Nurmohamed, Maarten H Christiaans, Jaap J Homan van der Heide, Thomas P A Debray, Fréderike J Bemelman
Background: Delayed graft function (DGF) is a common complication after kidney transplantation in the era of accepting an equal number of brain- and circulatory-death donor kidneys in the Netherlands. To identify those cases with an increased risk of developing DGF, various multivariable algorithms have been proposed. The objective was to validate the reproducibility of four predictive algorithms by Irish et al. (A risk prediction model for delayed graft function in the current era of deceased donor renal transplantation...
February 16, 2018: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/29461660/outcomes-at-7-years-post-transplant-in-black-versus-non-black-kidney-transplant-recipients-administered-belatacept-or-cyclosporine-in-benefit-and-benefit-ext
#8
Sander Florman, Flavio Vincenti, Antoine Durrbach, Marwan Abouljoud, Barbara Bresnahan, Valter Duro Garcia, Laura Mulloy, Kim Rice, Lionel Rostaing, Carlos Zayas, Kellie Calderon, Ulf Meier-Kriesche, Martin Polinsky, Lingfeng Yang, Jose Medina Pestana, Christian P Larsen
Clinical outcomes are generally worse for black versus non-black renal allograft recipients. In BENEFIT and BENEFIT-EXT, recipients were randomized to belatacept more-intense-based, belatacept less-intense-based, or cyclosporine-based immunosuppression. At year 7, belatacept was associated with superior graft survival versus cyclosporine in BENEFIT (recipients of living or standard criteria deceased donor kidneys); belatacept was associated with similar graft survival versus cyclosporine in BENEFIT-EXT (recipients of extended criteria donor kidneys)...
February 20, 2018: Clinical Transplantation
https://www.readbyqxmd.com/read/29457045/efficacy-of-endoscopic-retrograde-cholangiopancreatography-in-the-treatment-of-biliary-complications-following-liver-transplant-10-years-of-a-single-centre-experience
#9
Ana Rita Alves, Dário Gomes, Emanuel Furtado, Luís Tomé
Background and Aims: Biliary tract complications following liver transplant remain an important source of morbidity and mortality. Endoscopic retrograde cholangiopancreatography (ERCP) has become a common therapeutic option before other invasive procedures. The aim of this study was to evaluate ERCP efficacy in managing this type of complications. Methods: Retrospective study of all patients who underwent therapeutic ERCP due to post-liver transplant biliary complications between September 2005 and September 2015, at a deceased donor liver transplantation centre...
January 2018: GE Portuguese Journal of Gastroenterology
https://www.readbyqxmd.com/read/29456223/knowledge-and-attitude-toward-organ-donation-among-people-in-lanja-a-rural-town-in-india
#10
Vaishaly K Bharambe, Vasanti U Arole, Vatsalaswamy Puranam, Preeti P Kulkarni, Prashant B Kulkarni
Organ shortage is the greatest challenge facing the field of organ transplantation today. We aimed to study the attitude and knowledge toward body and organ donation among people in rural India. The present study was conducted in a rural town called Lanja, in the Konkan region of Maharashtra in India. A questionnaire covering demographic data, knowledge, and attitude of the participants was distributed to 400 students, middle-aged and senior citizens; 91.5% of the respondents were aware about organ donation...
January 2018: Saudi Journal of Kidney Diseases and Transplantation
https://www.readbyqxmd.com/read/29455437/live-donor-liver-transplantation-for-acute-liver-failure-a-single-center-experience
#11
Siddharth Mehrotra, Naimish Mehta, Prashantha S Rao, Shailendra Lalwani, Vivek Mangla, Samiran Nundy
INTRODUCTION: Acute liver failure (ALF) is an indication for emergency liver transplantation (LT). Although centers performing only deceased donor liver transplants (DDLT) have shown improved outcomes in this situation, they still have relatively long waiting lists. An alternative would be living donor liver transplantation (LDLT), which has shown equivalent outcomes in the elective situation but there is limited evidence of its results in ALF. AIM: The purpose of this study was to assess the outcomes in patients with ALF undergoing emergency LDLT in our center in Delhi, India...
February 17, 2018: Indian Journal of Gastroenterology: Official Journal of the Indian Society of Gastroenterology
https://www.readbyqxmd.com/read/29453882/early-kidney-allograft-loss-is-there-scope-for-improvement
#12
Paolo Ferrari
Increased longevity matching using Kidney Donor Profile Index (KDPI) to optimize long-term kidney allograft survival has been central to the effort of appropriate allocation of deceased donor kidneys. The data by Helenterä and co-workers in this issue, who looked at predictors of early allograft loss, should prompt an analysis of whether predictors of short-term graft survival can improve KDPI-based decisions when considering whether to accept or decline a deceased donor kidney offer. This article is protected by copyright...
February 17, 2018: Transplant International: Official Journal of the European Society for Organ Transplantation
https://www.readbyqxmd.com/read/29452208/outcome-of-abo-incompatible-adult-living-donor-liver-transplantation-for-patients-with-hepatocellular-carcinoma
#13
Young-In Yoon, Gi-Won Song, Sung-Gyu Lee, Shin Hwang, Ki-Hun Kim, Seok-Hwan Kim, Woo-Hyoung Kang, Hwui-Dong Cho, Eun-Kyoung Jwa, Jae-Hyun Kwon, Eun-Young Tak, Varvara A Kirchner
BACKGROUND & AIMS: Living-donor liver transplantation (LDLT) can simultaneously cure hepatocellular carcinoma (HCC) and underlying liver cirrhosis, improving long-term results in patients with HCC. ABO-incompatible LDLT could expand the living-donor pool, reduce waiting times for deceased-donor liver transplantation, and improve long-term survival for some patients with HCC. METHODS: We retrospectively reviewed the medical records of patients undergoing LDLT for HCC from November 2008 to December 2015 at a single institution in Korea...
February 13, 2018: Journal of Hepatology
https://www.readbyqxmd.com/read/29451354/are-we-underestimating-the-quality-of-aviremic-hepatitis-c-positive-kidneys-time-to-reconsider
#14
L Sibulesky, C E Kling, C Blosser, C K Johnson, A P Limaye, R Bakthavatsalam, N Leca, J D Perkins
KDRI introduced in 2009 included Hepatitis C serologic but not viremic status of the donors. With NAT testing now being mandatory, further evaluation of these donors is possible. We conducted a retrospective matched case-control analysis of adult deceased donor kidney transplants performed between 12/5/2014 to 12/31/2016 with the KDRI score and HCV Ab and NAT testing status obtained from UNOS database. The 205 aviremic Hep C Ab+ NAT - kidney transplants were compared to KDRI matched control kidneys that were Hep C Ab-NAT-...
February 16, 2018: American Journal of Transplantation
https://www.readbyqxmd.com/read/29451350/an-economic-assessment-of-contemporary-kidney-transplant-practice
#15
David Axelrod, Mark A Schnitzler, Huiling Xiao, William Irish, Elizabeth Tuttle-Newhall, Su-Hsin Chang, Bertram L Kasiske, Tarek Alhamad, Krista L Lentine
Kidney transplant is the optimal therapy for end stage renal disease, prolonging survival and reducing healthcare spending. Prior economic analyses of kidney transplant using Markov models, have generally assumed compatible, low risk, donors. The economic implications of using deceased donor kidneys with high kidney donor profile index (KPDI) scores, ABO incompatible or HLA incompatible living donors has not been assessed. The costs of transplant and dialysis were compared using discrete event simulation over a 10-year period, using data from the United States Renal Data System, Vizient ™ (Irving, Texas), and literature review...
February 16, 2018: American Journal of Transplantation
https://www.readbyqxmd.com/read/29448990/open-abdomen-in-liver-transplantation
#16
T Chan, M S Bleszynski, D S Youssef, M Segedi, S Chung, C H Scudamore, A K Buczkowski
INTRODUCTION: Damage control laparotomy with vacuum assisted closure (VAC) is used for selective cases in trauma. In liver transplantation, VAC has also been applied for management of intra-operative hemorrhage. The primary objective was to evaluate peri-operative blood loss and blood product utilization in VAC compared to primary abdominal closure (PAC) at the index transplant operation. METHODS: Retrospective review of all adults undergoing deceased donor liver transplantation (2007-2011) at a single center tertiary care institution...
January 31, 2018: American Journal of Surgery
https://www.readbyqxmd.com/read/29446738/how-do-dendritic-cells-play-the-role-in-ischemia-reperfusion-triggered-kidney-allograft-rejection
#17
Songjie Cai, Naotsugu Ichimaru, Shiro Takahara
In deceased donors, ischemia/reperfusion injury (IRI) is an important cause of allograft dysfunction. Prolonged cold and warm ischemia time leads to a high risk of early post-transplant complications, including acute and chronic rejection. Ischemia not only up-regulates inflammatory cytokines and chemokines, but also enhances the expression of MHC-class II and adhesion molecules on epithelial and dendritic cells. Moreover, the danger associated molecular patterns (DAMPs) released from stressed or dying cells, not only cause or amplify tissue inflammation and trigger tissue repair in response to IRI, but also act as adjuvants that enhance DC maturation and potentiate the adaptive immune response...
February 13, 2018: Current Gene Therapy
https://www.readbyqxmd.com/read/29446251/a-novel-technique-for-en-bloc-kidney-transplantation-from-infant-donors-with-extremely-low-body-weight-by-using-the-distal-abdominal-aorta-as-an-outflow-tract
#18
Helong Dai, Longkai Peng, Fenghua Peng, Gongbin Lan, Yu Wang, Jingjing Chen, Lei Liu, Chen Gao, Yong Guo, Chunhua Fang, Manhua Nie, Wang Long, Shaojie Yu
Pediatric kidney donors remain underutilized due to the high risk of postoperative thrombosis. To address this problem, we developed a novel en bloc kidney transplantation technique using donor thoracic aorta and the distal abdominal aorta as inflow and outflow tracts, respectively. Briefly, 8 kidneys from deceased infant donors under 5 months old and with low body weight (1.9-4.9 kg) were transplanted en bloc into 4 pediatric and 4 adult patients. The donor's common iliac artery or external iliac artery was anastomosed to the recipient's distal external iliac artery or inferior epigastric artery, respectively, as an outflow tract...
February 15, 2018: American Journal of Transplantation
https://www.readbyqxmd.com/read/29442469/brain-death-associated-pathological-events-and-therapeutic-options
#19
REVIEW
Paweł Chudoba, Wojciech Krajewski, Joanna Wojciechowska, Dorota Kamińska
BACKGROUND: At present, organ transplantation is the most efficient treatment of end-stage failure of various organs, including the heart, lungs, pancreas, intestines, kidney, and liver. Despite the efforts to use organs from living donors or from donors after circulatory death, most of the organs are recovered from brain dead (BD) donors. METHODS: The Medline and Web of Science databases were searched without time limit on November 2015 using the terms "brain dead donor" and "deceased donor" in conjunction with "transplantation", "graft", "organ", "hemodynamic", "hormonal", or "management"...
December 2017: Advances in Clinical and Experimental Medicine: Official Organ Wroclaw Medical University
https://www.readbyqxmd.com/read/29442420/a-liver-for-a-kidney-ethics-of-trans-organ-paired-exchange
#20
Benjamin Samstein, Inmaculada de Melo-Martin, Sandip Kapur, Lloyd Ratner, Jean Emond
Living donation provides important access to organ transplantation, which is the optimal therapy for patients with end-stage liver or kidney failure. Paired exchanges have facilitated thousands of kidney transplants and enable transplantation when the donor and recipient are incompatible. However, frequently willing and otherwise healthy donors have contraindications to donation of the organ that their recipient needs. Trans-organ paired exchanges would enable a donor associated with a kidney recipient to donate a lobe of liver and a donor associated with a liver recipient to donate a kidney...
February 14, 2018: American Journal of Transplantation
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