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Kidney transplant donor

Wenjun Shang, Yuefeng Shen, Shilin Gao, Guiwen Feng, Yonghua Feng, Zhigang Wang, Xiaobai Zhang
Chronic kidney disease is becoming a global public health problem, which will usually cause uremia at the end stage of chronic kidney failure. So far, kidney transplant is the most effective and proper therapy for uremia, however, the short supply of matched donor kidney has been a persistent bottleneck for transplantation. HLA matching of HLA-A, -B and -DRB1 loci is very important for the allocation of kidney transplants. In this study, we investigated genotypes of HLA-A, -B and -DRB1 loci based on 1,464 uremia patients and 10,000 unrelated healthy individuals in Henan province of China, and compared the frequency distribution of these HLA alleles and corresponding haplotypes between patient and healthy groups...
2016: PloS One
Johan De Meester
From late nineteen nineties, the higher number of suitable renal transplant candidates has forced the transplant community to re-explore the whole spectrum of deceased donors after brain death (DBD) as well as after cardiac death (DCD); in practice, donors of older age and donors with more chronic diseases or "medical complexities". This new kidney donor population - finally defined as extended criteria donors (ECD) - currently comprises on average 20 to 25%. In his seminal paper in 2003 on the introduction of ECD in the US, Metzger et al...
October 25, 2016: Transplant International: Official Journal of the European Society for Organ Transplantation
S Mittal, A Adamusiak, C Horsfield, I Loukopoulos, N Karydis, N Kessaris, M Drage, J Olsburgh, Cje Watson, C J Callaghan
BACKGROUND: A significant proportion of procured deceased donor kidneys are subsequently discarded. The UK Kidney Fast-Track Scheme (KFTS) was introduced in 2012, enabling kidneys at risk of discard to be simultaneously offered to participating centres. We undertook an analysis of discarded kidneys to determine if unnecessary organ discard was still occurring since the KFTS was introduced. METHODS: Between April and June 2015, senior surgeons independently inspected 31 consecutive discarded kidneys from throughout the UK...
October 25, 2016: Transplantation
Lin Yan, Yi Li, Jiang-Tao Tang, Yun-Fei An, Li-Mei Luo, Bo Dai, Yun-Ying Shi, Lan-Lan Wang
OBJECTIVE: A genome-wide association study has identified several gene polymorphisms associated with loss of renal function. The effect of these variants on renal function in kidney transplant recipients receiving immunosuppressive treatment is unknown. MATERIALS AND METHODS: A cohort of 189 kidney transplant recipients and their living donors were recruited from West China Hospital of Sichuan University, on whom we assessed the association of five single nucleotide polymorphisms with renal function after kidney transplantation...
October 24, 2016: Pharmacogenetics and Genomics
Jia Loon Chong
Kidney transplantation is the preferred treatment for eligible end-stage renal disease patients. However, the supply of donated kidneys has been consistently insufficient to meet the transplantation requirements of the population. In this paper, I discuss the feasibility of several policy options that engage potential donors or key individuals in a Singapore context, including financial and non-financial incentives for deceased/living organ donors and their families, improving actualisation rates of both donation after brain death, donation after cardiac death through quality improvement programmes and remuneration schemes, and a media platform for directed organ donation...
October 2016: Singapore Medical Journal
Rosa M Michel Ortega, Daynna J Wolff, Cynthia A Schandl, Harry A Drabkin
BACKGROUND: Malignancy after transplantation is an uncommon multifactorial occurrence. Immunosuppression to prevent graft rejection is described as a major risk factor in malignancy development in the post-transplant state. Donor-derived malignancy is a rare reported complication. Herein, we review our patient history and discuss diagnostic strategies and the implications of immunosuppression for donor-derived malignancy. CASE PRESENTATION: This is a 69-year-old man with post-renal-transplant urothelial carcinoma determined to be of donor origin...
2016: Journal for Immunotherapy of Cancer
Mani Nagarajan, Sakthirajan Ramanathan, Jeyachandran Dhanapriya, Thanigachalam Dineshkumar, T Bala Subramaniyan, Natarajan Gopalakrishnan
BACKGROUND: Acute kidney injury (AKI) is one of the major determinants of graft survival in kidney transplantation (KTx). Renal Transplant recipients are more vulnerable to develop AKI than general population. AKI in the transplant recipient differs from community acquired, in terms of risk factors, etiology and outcome. Our aim was to study the incidence, risk factors, etiology, outcome and the impact of AKI on graft survival. METHODS: A retrospective analysis of 219 renal transplant recipients (both live and deceased donor) was done...
October 24, 2016: Renal Failure
Simon R Knight, Leanne Metcalfe, Katriona O'Donoghue, Simon T Ball, Angela Beale, William Beale, Rachel Hilton, Keith Hodkinson, Graham W Lipkin, Fiona Loud, Lorna P Marson, Peter J Morris
BACKGROUND: It has been suggested that the research priorities of those funding and performing research in transplantation may differ from those of end service users such as patients, carers and healthcare professionals involved in day-to-day care. The Kidney Transplant Priority Setting Partnership (PSP) was established with the aim of involving all stakeholders in prioritising future research in the field. METHODS: The PSP methodology is as outlined by the James Lind Alliance...
2016: PloS One
Annabelle Pourbaix, Nacera Ouali, Patrick Soussan, Anne Marie Roque Afonso, Marie-Noelle Péraldi, Eric Rondeau, Julie Peltier
Hepatitis E virus (HEV) can cause chronic infection among immunocompromised patients, especially solid organ transplant (SOT) recipients, and can evolve to cirrhosis. Several modes of transmission are known. Here we describe the first 2 cases, to our knowledge, of HEV infection transmitted by a kidney graft from the same infected donor that led to chronic hepatitis. Consequently, systematic screening of donors by HEV serology and HEV RNA detection by polymerase chain reaction, particularly in endemic regions, should be considered...
October 24, 2016: Transplant Infectious Disease: An Official Journal of the Transplantation Society
Ronald F Parsons, Jayme E Locke, Robert R Redfield, Garrett R Roll, Matthew H Levine
Deceased donor kidney allocation was reorganized in the United States to address several problems, including the highly sensitized patients disadvantaged with large, diverse repertoires of antibodies. Here, five transplant surgeons review their center's experience with the new allocation changes: highlighting areas of accomplishment, opportunities for improvement and, in some cases, stark differences in practice. Across these five centers the highly sensitized patients (CPRA ⩾98%) range from 5.5 to 9.2% of the 12,364 candidates on their collective waitlist...
October 20, 2016: Human Immunology
Rene J Duquesnoy
The new kidney allocation system (KAS) still applies donor-recipient HLA compatibility mostly at the antigen level and although some four-digit alleles have been included. This system is used to record unacceptable mismatches for sensitized transplant candidates with serum HLA antibodies. Since the reactivities of such antibodies are specifically associated with epitopes rather than HLA antigens, a more scientifically accurate assessment of mismatch acceptability could be based on epitopes. HLA class I and class II epitope specificity analyses can now be readily performed with serum antibody assays with single allele panels...
October 19, 2016: Human Immunology
Meghan B Brennan, Barbara L Herwaldt, James J Kazmierczak, John W Weiss, Christina L Klein, Catherine P Leith, Rong He, Matthew J Oberley, Laura Tonnetti, Patricia P Wilkins, Gregory M Gauthier
Babesia microti, an intraerythrocytic parasite, is tickborne in nature. In contrast to transmission by blood transfusion, which has been well documented, transmission associated with solid organ transplantation has not been reported. We describe parasitologically confirmed cases of babesiosis diagnosed ≈8 weeks posttransplantation in 2 recipients of renal allografts from an organ donor who was multiply transfused on the day he died from traumatic injuries. The organ donor and recipients had no identified risk factors for tickborne infection...
November 2016: Emerging Infectious Diseases
Q A Hill, L C Harrison, A D Padmakumar, R G Owen, K R Prasad, G F Lucas, P Tachtatzis
OBJECTIVE AND IMPORTANCE: Transplantation-mediated alloimmune thrombocytopenia (TMAT) occurs when leukocytes transferred in a donor organ from a patient with immune thrombocytopenia (ITP), mount a response against recipient platelets. We present the first fatal case of TMAT following liver transplantation and review its aetiology and treatment. CLINICAL PRESENTATION: The liver donor had ITP and died from an intracranial haemorrhage. The recipient platelet count fell to 2 × 10(9)/l on post-operative day 2...
October 21, 2016: Hematology (Amsterdam, Netherlands)
Byung Ha Chung, Jeong Ho Kim, Bum Soon Choi, Cheol Whee Park, Ji-Il Kim, In Sung Moon, Yong-Soo Kim, Yeong Jin Choi, Eun-Jee Oh, Chul Woo Yang
Background/Aims: This study investigated the clinical significance of detecting anti-human leukocyte antigen-donor specific antibody (HLA-DSA) in kidney transplant recipients (KTRs) requiring indication biopsy owing to allograft dysfunction. Methods: We analyzed the presence of HLA-DSA in 210 KTRs who took indication biopsy. We divided these cases into two groups, HLA-DSA (+) (n = 52) and HLA-DSA (-) (n = 158) group, and compared the clinical characteristics, pathological findings, and clinical outcomes of the two groups...
October 20, 2016: Korean Journal of Internal Medicine
Darren E Stewart, Victoria C Garcia, John D Rosendale, David K Klassen, Bob J Carrico
BACKGROUND: The proportion of deceased donor kidneys recovered for transplant but discarded increased steadily in the U.S. over 2 decades, from 5.1% in 1988 to 19.2% by 2009. Over 100,000 patients are waiting for a kidney transplant, yet 3,159 kidneys were discarded in 2015. METHODS: We evaluated trends in donor characteristics, discard reasons, and OPO-specific discard rates. Multivariable regression and propensity analysis were used to estimate the proportion of the discard rate rise in the 2000's attributable to changes in donor factors and decisions to biopsy and pump kidneys...
October 19, 2016: Transplantation
Kohei Naoki, Hideaki Takada, Kosuke Hishiki, Yoshiharu Nakashima, Koji Yoshimura, Yasunori Nishio, Kenta Ito, Ken Matsuo, Noriko Mori
A 24-year-old woman with a high fever presented at our hospital. She had been diagnosed with Kabuki syndrome at the age of 4 years because she had the typical facial features of the condition ; she had undergone living donor renal transplantation 12 years prior. She was prescribed a course of antibiotics to treat pyelonephritis of the transplanted kidney and the high fever disappeared, but the fever developed again 3 days after the discharge. Abdominal computed tomography revealed a tubular structure of recent onset running from the left dorsal side to the lower part of the bladder...
September 2016: Hinyokika Kiyo. Acta Urologica Japonica
Sentaro Imamura, Shintaro Narita, Ryuta Nishikomori, Hiroshi Tsuruta, Kazuyuki Numakura, Atsushi Maeno, Mitsuru Saito, Takamitsu Inoue, Norihiko Tsuchiya, Hiroshi Nanjo, Toshio Heike, Shigeru Satoh, Tomonori Habuchi
BACKGROUND: Secondary bladder amyloidosis is an extremely rare disease, resulting from a chronic systematic inflammatory disorder associated with amyloid deposits. Although uncommon in Japan, familial Mediterranean fever (FMF) is a hereditary autoinflammatory disease characterized by recurrent episodes of fever of short duration and serositis and is frequently associated with systemic amyloidosis. Here, we present a case of a Japanese patient complaining of fever and macroscopic hematuria after a living donor renal transplantation...
October 19, 2016: BMC Research Notes
Takahisa Hiramitsu, Manabu Okada, Kenta Futamura, Takayuki Yamamoto, Makoto Tsujita, Norihiko Goto, Shunji Narumi, Yoshihiko Watarai
This study aimed to investigate the impact of grafting using thin upper pole artery ligation for living-donor adult kidney transplantation. Few reports have examined the safety of thin upper pole artery ligation.Between January 2008 and May 2015, 613 consecutive living-donor adult kidney transplantations were performed. We excluded 21 recipients who experienced graft loss due to factors that were unrelated to surgical complications and 3 recipients with grafts treated with arterial reconstruction and thin upper pole artery ligation for 3 arteries...
October 2016: Medicine (Baltimore)
Abbas Rana, Eileen D Brewer, Brandi B Scully, Michael L Kueht, Matt Goss, Karim J Halazun, Hao Liu, N Thao N Galvan, Ronald T Cotton, Christine A O'Mahony
BACKGROUND: Low case volume has been associated with worse survival outcomes in solid organ transplantation. Our aim was to analyze wait-list outcomes in conjunction with posttransplant outcomes. METHODS: We studied a cohort of 11,488 candidates waitlisted in the Organ Procurement and Transplantation Network (OPTN) for pediatric kidney transplant between 2002 and 2014, including both deceased- and living-donor transplants; 8757 (76 %) candidates received a transplant...
October 18, 2016: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
Benjamin M Anderson, Jemma L Mytton, Felicity Evison, Charles J Ferro, Adnan Sharif
INTRODUCTION: Outcomes for weekend hospital admissions or emergency procedures have become a topical and controversial issue for the UK National Health Service (NHS). Deceased-donor kidney transplantation is frequently performed at weekends and evidence for its relative safety are lacking. METHODS: We undertook a population-based cohort analysis, obtaining data from every deceased-donor kidney-alone transplant procedure performed in England between January 2003 and December 2014...
October 17, 2016: Transplantation
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