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Kidney transplant donor

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https://www.readbyqxmd.com/read/28077080/should-patients-older-than-65-years-be-offered-a-second-kidney-transplant
#1
Kristian Heldal, Anders Hartmann, Kjersti Lønning, Torbjørn Leivestad, Anna V Reisæter, Pål-Dag Line, Hallvard Holdaas, Karsten Midtvedt
BACKGROUND: Age and number of recipients in need of kidney re-transplantation are increasing. Re-transplantation practices and outcomes in elderly recipients are not previously explored. We aimed to retrospectively evaluate the outcomes of recipients 65 years and older receiving their second deceased donor allograft. METHODS: The study was designed as a retrospective registry based study. All recipients 65 years or older who received a deceased donor kidney transplant at Oslo University Hospital between 2000 and 2014 were included in the study...
January 11, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/28076340/telomere-length-assessment-for-prediction-of-organ-transplantation-outcome-future-or-failure-a-review-of-the-literature
#2
Karolina Kłoda, Leszek Domański, Artur Mierzecki
Telomeres are located at each end of eukaryotic chromosomes. Their functional role is genomic stability maintenance. The protective role of telomeres depends on various factors, including number of nucleotides repeats, telomere-binding proteins, and telomerase activity. Organ transplantation is the preferred replacement therapy in the case of chronic kidney disease and the only possibility of sustaining recipients' life in the case of advanced liver failure. While the prevalence of acute rejection is constantly decreasing, prevention of transplanted organ long-term function loss is still challenging...
January 11, 2017: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
https://www.readbyqxmd.com/read/28072755/strategies-for-an-expanded-use-of-kidneys-from-elderly-donors
#3
María José Pérez-Sáez, Nuria Montero, Dolores Redondo-Pachón, Marta Crespo, Julio Pascual
The old-for-old allocation policy used for kidney transplantation (KT) has confirmed the survival benefit compared to remaining listed on dialysis. Shortage of standard donors has stimulated the development of strategies aimed to expand acceptance criteria, particularly of kidneys from elderly donors. We have systematically reviewed the literature on those different strategies. In addition to the review of outcomes of expanded criteria donor (ECD) or advanced age kidneys, we assessed the value of the Kidney Donor Profile Index (KDPI) policy, preimplantation biopsy, dual KT, machine perfusion and special immunosuppressive protocols...
January 9, 2017: Transplantation
https://www.readbyqxmd.com/read/28069404/calculated-panel-reactive-antibody-with-decimals-a-refined-metric-of-access-to-transplantation-for-highly-sensitized-candidates
#4
Evan P Kransdorf, Marcelo J Pando
The use of the calculated panel reactive antibody (CPRA) value and the implementation of allocation points for sensitized candidates by the United Network for Organ Sharing (UNOS) have improved access to kidney transplantation for highly sensitized candidates (98% CPRA and above). Despite this, a large population of highly sensitized candidates remain awaiting transplantation. To better define this population, we propose the use of two refinements of the standard UNOS CPRA, the CPRA with decimals or CPRAd, and the likelihood of a compatible donor (LCD)...
January 6, 2017: Human Immunology
https://www.readbyqxmd.com/read/28065560/sense-and-sensitivity-incompatible-patients-and-their-donors-in-kidney-transplantation
#5
Peter P Reese, Sumit Mohan
No abstract text is available yet for this article.
January 5, 2017: Lancet
https://www.readbyqxmd.com/read/28065559/post-listing-survival-for-highly-sensitised-patients-on-the-uk-kidney-transplant-waiting-list-a-matched-cohort-analysis
#6
Miriam Manook, Leonardo Koeser, Zubir Ahmed, Matthew Robb, Rachel Johnson, Olivia Shaw, Nicos Kessaris, Anthony Dorling, Nizam Mamode
BACKGROUND: More than 40% of patients awaiting a kidney transplant in the UK are sensitised with human leucocyte antigen (HLA) antibodies. Median time to transplantation for such patients is double that of unsensitised patients at about 74 months. Removing antibody to perform an HLA-incompatible (HLAi) living donor transplantation is perceived to be high risk, although patient survival data are limited. We compared survival of patients opting for an HLAi kidney transplant with that of similarly sensitised patients awaiting a compatible organ...
January 5, 2017: Lancet
https://www.readbyqxmd.com/read/28065453/protective-effects-of-l-carnitine-against-delayed-graft-function-in-kidney-transplant-recipients-a-pilot-randomized-double-blinded-placebo-controlled-clinical-trial
#7
Atefeh Jafari, Mohammad-Reza Khatami, Simin Dashti-Khavidaki, Mahboob Lessan-Pezeshki, Alireza Abdollahi, Azadeh Moghaddas
OBJECTIVE: Delayed graft function (DGF) is an early complication after deceased donor kidney transplantation with significant adverse effects on graft outcomes. Ischemia-reperfusion injury during transplantation is a major cause of DGF. Tissue concentrations of carnitine, an antioxidant and regulator of cellular energy supply, decrease in the kidney following ischemia-reperfusion insult. Based on promising animal data, this study evaluated the possible protective effect of L-carnitine against DGF...
January 3, 2017: Journal of Renal Nutrition
https://www.readbyqxmd.com/read/28062436/contralateral-inguinal-herniation-of-a-transplant-ureter-causing-obstructive-uropathy-in-a-renal-transplant-recipient
#8
Niyati Lobo, Fiona McCaig, Jonathon Olsburgh
Ipsilateral inguinal herniation of the transplanted ureter has been reported as a rare cause of obstructive uropathy in renal transplant recipients. A 73-year-old man presented with acute renal failure 29 years after receiving a deceased donor renal transplant. Radiological investigations demonstrated marked hydronephrosis of the left iliac fossa transplant kidney and herniation of the distal transplant ureter and bladder into the right inguinal canal. The patient underwent placement of a nephrostomy and antegrade stent followed by definitive hernia repair with return of graft function to baseline level...
January 6, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28062320/melanised-fungal-infections-in-kidney-transplant-recipients-contributions-to-optimize-the-clinical-management
#9
Daniel Wagner de Castro Lima Santos, Luis Fernando Aranha Camargo, Sarah Santos Gonçalves, Marília Marufuji Ogawa, Jane Tomimori, Milvia Maria Simões E Silva Enokihara, José Osmar Medina Pestana, Arnaldo Lopes Colombo
OBJECTIVES: This is a retrospective and observational study addressing clinical and therapeutic aspects of melanised fungal infections in kidney transplant recipients. METHODS: We retrospectively reviewed medical records of all patients admitted between January 1996 and December 2013 in a single institution who developed infections by melanised fungi. RESULTS: We reported 56 patients aging between 30 and 74 years with phaeohyphomycosis or chromoblastomycosis (0...
January 3, 2017: Clinical Microbiology and Infection
https://www.readbyqxmd.com/read/28060446/successful-treatment-of-donor-derived-hepatitis-c-viral-infection-in-three-transplant-recipients-from-a-donor-at-increased-risk-for-bloodborne-pathogens
#10
Ashesh P Shah, Andrew Cameron, Pooja Singh, Adam M Frank, Jonathan M Fenkel
We report here the successful treatment of hepatitis C virus (HCV) transmitted from a nucleic acid testing (NAT)-negative donor to 3 HCV-negative recipients - 2 renal transplants and 1 liver. Both renal recipients underwent standard deceased-donor renal transplantation with immediate graft function. The liver recipient underwent standard orthotopic liver transplantation and recovered uneventfully. The donor was a 39-year-old woman with a terminal serum creatinine of 0.7 mg/dL. She was high risk for bloodborne pathogens, based upon a history of sexual contact with an HCV-infected male partner...
January 6, 2017: Transplant Infectious Disease: An Official Journal of the Transplantation Society
https://www.readbyqxmd.com/read/28060025/antibody-mediated-rejection-what-is-the-clinical-relevance
#11
Rachel Hogen, Joseph DiNorcia, Kiran Dhanireddy
PURPOSE OF REVIEW: The review outlines the diagnosis, clinical implications, and treatment strategies for acute and chronic antibody-mediated rejection (AMR) after orthotopic liver transplantation (OLT). RECENT FINDINGS: A combination of clinical work-up, histopathology, C4d staining, and donor-specific antibody (DSA) should be used to diagnose AMR. The differential diagnosis for idiopathic fibrosis now includes chronic AMR. Characterization of pathogenic DSA continues to progress...
January 3, 2017: Current Opinion in Organ Transplantation
https://www.readbyqxmd.com/read/28058222/stabilization-of-estimated-glomerular-filtration-rate-in-kidney-transplantation-from-deceased-donors-with-acute-kidney-injuries
#12
Punlop Wiwattanathum, Atiporn Ingsathit, Surasak Kantachuvesiri, Nuttapon Arpornsujaritkun, Wiwat Tirapanich, Vasant Sumethkul
AIM: To evaluate and compare the outcomes of kidney transplant (KT) from deceased donors among standard criteria, acute kidney injury (AKI) and expanded criteria donors (ECDs). METHODS: This retrospective study included 111 deceased donor kidney transplant recipients (DDKT). Deceased donors were classified as standard criteria donor (SCD), AKI donor and ECD. AKI was diagnosed and classified based on change of serum Cr by acute kidney injury network (AKIN) criteria...
December 24, 2016: World Journal of Transplantation
https://www.readbyqxmd.com/read/28058220/tacrolimus-confers-lower-acute-rejection-rates-and-better-renal-allograft-survival-compared-to-cyclosporine
#13
Mahmoud Kamel, Manish Kadian, Titte Srinivas, David Taber, Maria Aurora Posadas Salas
AIM: To compare the impact of tacrolimus (FK) and cyclosporine (CYA) on acute rejection and graft survival and to assess the predominant causes of graft loss between patients receiving these two calcineurin inhibitors (CNIs). METHODS: Retrospective review of 1835 patients who received a kidney transplant (KTX) between 1999-2012. Patients were grouped based on initial CNI utilized: 1195 in FK group, 640 in CYA group. Data on baseline characteristics, clinical outcomes, and causes of graft loss in both groups were analyzed...
December 24, 2016: World Journal of Transplantation
https://www.readbyqxmd.com/read/28058219/impact-of-preformed-donor-specific-antibodies-against-hla-class-i-on-kidney-graft-outcomes-comparative-analysis-of-exclusively-anti-cw-vs-anti-a-and-or-b-antibodies
#14
Sofia Santos, Jorge Malheiro, Sandra Tafulo, Leonídio Dias, Rute Carmo, Susana Sampaio, Marta Costa, Andreia Campos, Sofia Pedroso, Manuela Almeida, La Salete Martins, Castro Henriques, António Cabrita
AIM: To analyze the clinical impact of preformed antiHLA-Cw vs antiHLA-A and/or -B donor-specific antibodies (DSA) in kidney transplantation. METHODS: Retrospective study, comparing 12 patients transplanted with DSA exclusively antiHLA-Cw with 23 patients with preformed DSA antiHLA-A and/or B. RESULTS: One year after transplantation there were no differences in terms of acute rejection between the two groups (3 and 6 cases, respectively in the DSA-Cw and the DSA-A-B groups; P = 1)...
December 24, 2016: World Journal of Transplantation
https://www.readbyqxmd.com/read/28058214/older-candidates-for-kidney-transplantation-who-to-refer-and-what-to-expect
#15
REVIEW
Beatrice P Concepcion, Rachel C Forbes, Heidi M Schaefer
The number of older end-stage renal disease patients being referred for kidney transplantation continues to increase. This rise is occurring alongside the continually increasing prevalence of older end-stage renal disease patients. Although older kidney transplant recipients have decreased patient and graft survival compared to younger patients, transplantation in this patient population is pursued due to the survival advantage that it confers over remaining on the deceased donor waiting list. The upper limit of age and the extent of comorbidity and frailty at which transplantation ceases to be advantageous is not known...
December 24, 2016: World Journal of Transplantation
https://www.readbyqxmd.com/read/28058212/complement-related-kidney-diseases-recurrence-after-transplantation
#16
REVIEW
Maurizio Salvadori, Elisabetta Bertoni
The recurrence of renal disease after renal transplantation is becoming one of the main causes of graft loss after kidney transplantation. This principally concerns some of the original diseases as the atypical hemolytic uremic syndrome (HUS), the membranoproliferative glomerulonephritis (MPGN), in particular the MPGN now called C3 glomerulopathy. Both this groups of renal diseases are characterized by congenital (genetic) or acquired (auto-antibodies) modifications of the alternative pathway of complement...
December 24, 2016: World Journal of Transplantation
https://www.readbyqxmd.com/read/28058211/organ-transplantation-and-drug-eluting-stents-perioperative-challenges
#17
REVIEW
Aparna Dalal
Patients listed for organ transplant frequently have severe coronary artery disease (CAD), which may be treated with drug eluting stents (DES). Everolimus and zotarolimus eluting stents are commonly used. Newer generation biolimus and novolimus eluting biodegradable stents are becoming increasingly popular. Patients undergoing transplant surgery soon after the placement of DES are at increased risk of stent thrombosis (ST) in the perioperative period. Dual antiplatelet therapy (DAPT) with aspirin and a P2Y12 inhibitor such as clopidogrel, prasugrel and ticagrelor is instated post stenting to decrease the incident of ST...
December 24, 2016: World Journal of Transplantation
https://www.readbyqxmd.com/read/28052685/occurrence-of-malignancies-after-kidney-transplantation-in-adults-slovak-multicenter-experience
#18
Z Zilinska, M Sersenova, M Chrastina, J Breza Sr, L Bena, T Baltesova, A Jurcina, R Roland, E Lackova, M Cellar, L Laca, I Dedinska
Malignancies are one of the three major causes of renal recipient´s death with a functioning graft after cardiovascular diseases and infections. Among the variety of risk factors, including conventional and specific to transplant recipients, the duration of immunosuppressive therapy, the intensity of therapy, and the type of immunosuppressive agent all have an impact on development of post-transplant malignancy. The aim of our retrospective study was to document the incidence, the type of malignancies, the patient/graft survival in the group of kidney transplant recipients in Slovak Republic, and to identify the factors which influenced the outcome...
January 5, 2017: Neoplasma
https://www.readbyqxmd.com/read/28052609/optn-srtr-2015-annual-data-report-kidney
#19
A Hart, J M Smith, M A Skeans, S K Gustafson, D E Stewart, W S Cherikh, J L Wainright, A Kucheryavaya, M Woodbury, J J Snyder, B L Kasiske, A K Israni
The first full year of data after implementation of the new kidney allocation system reveals an increase in deceased donor kidney transplants among black candidates and those with calculated panel-reactive antibodies 98%-100%, but a decrease among candidates aged 65 years or older. Data from 2015 also demonstrate ongoing positive trends in graft and patient survival for both deceased and living donor kidney transplants, but the challenges of a limited supply of kidneys in the setting of increasing demand remain evident...
January 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/28052608/optn-srtr-2015-annual-data-report-deceased-organ-donation
#20
A K Israni, D Zaun, C Bolch, J D Rosendale, C Schaffhausen, J J Snyder, B L Kasiske
SRTR uses data collected by OPTN to calculate metrics such as donation/conversion rate, organ yield, and rate of organs recovered for transplant but not transplanted. In 2015, 1,072,828 death and imminent death referrals were made to Organ Procurement Organizations, of which 21,559 met the definition of eligible (9793) or imminent (11,766) deaths per OPTN policy. The number of deceased donors was 9080, and this number has been increasing since 2010. The number of organs authorized for recovery increased slightly to 65,086 in 2015, and the number recovered increased slightly to 25,762...
January 2017: American Journal of Transplantation
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