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https://www.readbyqxmd.com/read/28722099/-results-of-a-representative-survey-on-the-psychosocial-evaluation-before-living-donor-kidney-transplantation-in-germany
#1
Martina de Zwaan, Yesim Erim, Gertrud Greif-Higer, Sylvia Kröncke, Markus Burgmer, Frank Vitinius, Sabine Kunze, Hendrik Berth
Aim Since there is no consensus about how to perform the predonation psychosocial evaluation of living kidney donor candidates, this is conducted differently in German transplant centers. Thus, the goal of the study was to learn more about how psychosocial evaluations are currently conducted in German transplant centers. Methods The psychosocial evaluators of the 38 transplant centers performing kidney transplantations in 2015 were contacted and asked to participate in an anonymous online survey. Results Psychosocial evaluators from 28 (75%) transplant centers responded...
June 2017: Psychotherapie, Psychosomatik, Medizinische Psychologie
https://www.readbyqxmd.com/read/28712148/influence-of-kidney-offer-acceptance-behavior-on-metrics-of-allocation-efficiency
#2
Andrew Wey, Nicholas Salkowski, Bertram L Kasiske, Ajay K Israni, Jon J Snyder
We investigated associations of deceased donor kidney offer acceptance with likelihood of the kidney being discarded, cold ischemia time at transplant (CIT), and likelihood of the kidney being exported outside the donation service area (DSA). We used kidney offers from donors in the Scientific Registry of Transplant Recipients July 1, 2015-June 30, 2016, and a stratified logistic regression to estimate odds ratios of acceptance for candidates waitlisted in a DSA. We estimated associations between these ratios and likelihood of discard or export and CIT at transplant...
July 16, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/28705554/atrial-function-atrial-volume-and-cardiovascular-clinical-outcomes-in-patients-with-end-stage-renal-disease-a-study-of-cardiac-computed-tomography
#3
Laust Dupont, Simon Winther, Hanne Skou Jørgensen, Peter Bomholt, Hans Erik Bøtker, Morten Bøttcher, Per Ivarsen, My Svensson
BACKGROUND: Patients with chronic kidney disease (CKD) have an increased risk of cardiovascular events. Previous studies using 2-dimensional echocardiography show that left atrial end-diastolic volume (LAEDV) predicts cardiovascular outcomes and mortality in patients with CKD. However, contrast-enhanced cardiac CT may offers a more precise measure of atrial dimensions and function than 2-dimensional echocardiography and may provide improved predictionof patient outcome. AIM: The aim of the present study was to examine the association of LAEDV and left atrial ejection fraction (LAEF) assessed by CT with left ventricle end-diastolic volume (LVEDV), left ventricular mass, left ventricular ejection fraction and N-terminal plasma-pro-brain natriuretic peptide (NT-PRO-BNP)...
July 4, 2017: Journal of Cardiovascular Computed Tomography
https://www.readbyqxmd.com/read/28704488/soluble-st2-does-not-change-cardiovascular-risk-prediction-compared-to-cardiac-troponin-t-in-kidney-transplant-candidates
#4
Mira T Keddis, Ziad El-Zoghby, Bruce Kaplan, Jeffrey W Meeusen, Leslie J Donato, Fernando G Cosio, D Eric Steidley
BACKGROUND: Solubility of Tumorigenicity 2 (sST2) is a novel biomarker that better stratifies risk of cardiovascular events (CVE) compared to cardiac troponin T(cTnT) in heart failure. We assessed the association of sST2 with the composite outcome of CVE and/or mortality compared to cTnT in kidney transplant candidates. METHODS: 200 kidney transplant candidates between 2010 and 2013 were included. Elevated sST2 was defined as ≥30ng/ml, cTnT≥0.01 ng/ml. RESULTS: Median age 53 (interquartile range (IQR) 42-61) years, 59...
2017: PloS One
https://www.readbyqxmd.com/read/28692441/histocompatibility-and-management-of-the-highly-sensitized-kidney-transplant-candidate
#5
Bonnie E Lonze
PURPOSE OF REVIEW: Increasing national participation in kidney paired donation and implementation of new sharing policies via the current kidney allocation system have brought about greater opportunities for the most highly sensitized patients awaiting a kidney transplant. The purpose of this review is to discuss the application of histocompatibility data in the context of the clinical practice of kidney transplantation as pertains to the sensitized candidate. RECENT FINDINGS: With desensitization techniques, transplantation across virtually any antibody barrier is technically feasible, but long-term outcomes after transplantation are improved when the immunologic match between donor and recipient is optimized...
August 2017: Current Opinion in Organ Transplantation
https://www.readbyqxmd.com/read/28685008/stress-spect-myocardial-perfusion-imaging-in-end-stage-renal-disease
#6
Yasmeen Golzar, Rami Doukky
PURPOSE OF REVIEW: Patients with end-stage renal disease (ESRD) have an increased risk of cardiovascular morbidity and mortality. Cardiac risk assessment, though challenging, is critical in these high-risk patients, particularly in the pre-transplant population. In this review, we discuss the burden of coronary artery disease in the ESRD population and review the literature on the diagnostic and prognostic performance, clinical value, and future directions of single-photon emission computed tomography (SPECT) myocardial perfusion imaging (MPI) in ESRD patients...
May 2017: Current Cardiovascular Imaging Reports
https://www.readbyqxmd.com/read/28677269/impact-of-a-pharmacist-led-vaccine-recommendation-program-for-pediatric-kidney-transplant-candidates
#7
Clarice E Carthon, Reed C Hall, Pamela R Maxwell, Barrett R Crowther
Pediatric transplant recipients commonly have deficient vaccination status at the time of transplantation. Utilizing transplant pharmacists to improve vaccination rates has not previously been described. This single-center, retrospective study evaluated the impact of transplant pharmacist interventions on the completion rate of vaccination schedules at time of kidney transplant. Patients who received pharmacist-led vaccination recommendations prior to transplant were compared to patients without pharmacist recommendations...
July 4, 2017: Pediatric Transplantation
https://www.readbyqxmd.com/read/28661314/effect-of-single-sensitization-event-on-human-leukocyte-antigen-alloimmunization-in-kidney-transplant-candidates-a-single-center-experience
#8
Marianna Resse, Rossella Paolillo, Biagio Pellegrino Minucci, Dario Costa, Carmela Fiorito, Michele Santangelo, Paride De Rosa, Claudio Napoli
OBJECTIVES: Human leukocyte antigen alloimmunization is caused by exposure to HLA antigens through transfusion, pregnancy, or transplant. Our study objective was to present the rate of positivity of anti-HLA antibody considering the effects of a single sensitization event in kidney transplant candidates at our center. MATERIALS AND METHODS: Our study reviewed 606 kidney transplant candidates. Patient sera were analyzed using Luminex xMAP technology. Panel reactive antibody positivity rates and antibody strengths in patients were analyzed according to a single sensitization event...
June 28, 2017: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/28661285/living-organ-donation-and-informed-consent-in-the-united-states-strategies-to-improve-the-process
#9
Macey L Henderson, Jed Adam Gross
About 6,000 individuals participate in the U.S. transplant system as a living organ donor each year. Organ donation (most commonly a kidney or part of liver) by living individuals is a unique procedure, where healthy patients undergo a major surgical operation without any direct functional benefit to themselves. In this article, the authors explore how the ideal of informed consent guides education and evaluation for living organ donation. The authors posit that informed consent for living organ donation is a process...
March 2017: Journal of Law, Medicine & Ethics: a Journal of the American Society of Law, Medicine & Ethics
https://www.readbyqxmd.com/read/28631103/transesophageal-echocardiography-in-orthotopic-liver-transplantation-a-comprehensive-intraoperative-monitoring-tool
#10
REVIEW
Luigi Vetrugno, Federico Barbariol, Umberto Baccarani, Francesco Forfori, Giovanni Volpicelli, Giorgio Della Rocca
Intraoperative transesophageal echocardiography is a minimally invasive monitoring tool that can provide real-time visual information on ventricular function and hemodynamic volume status in patients undergoing liver transplantation. The American Association for the Study of Liver Diseases states that transesophageal echocardiography should be used in all liver transplant candidates in order to assess chamber sizes, hypertrophy, systolic and diastolic function, valvular function, and left ventricle outflow tract obstruction...
December 2017: Critical Ultrasound Journal
https://www.readbyqxmd.com/read/28629552/comparative-analysis-of-four-scores-to-stratify-patients-with-heart-failure-and-reduced-ejection-fraction
#11
Pedro Freitas, Carlos Aguiar, António Ferreira, António Tralhão, António Ventosa, Miguel Mendes
There are several prognostic risk scores available for patients with heart failure with reduced ejection fraction (HFrEF) that can aid in the decision of listing candidates for heart transplant (HTx). A direct comparison between these scores has not been performed. Therefore, our objective was to evaluate the calibration and discriminative power of 4 contemporary HF scores. A retrospective analysis of 259 patients with HFrEF who underwent cardiopulmonary exercise test was conducted. The Heart Failure Survival Score (HFSS), Seattle Heart Failure Model (SHFM), Meta-analysis Global Group in Chronic Heart Failure (MAGGIC), and Metabolic Exercise Cardiac Kidney Index (MECKI) were compared...
August 1, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28624980/emerging-biomarkers-of-chronic-kidney-disease-in-children
#12
REVIEW
Jason H Greenberg, Aadil Kakajiwala, Chirag R Parikh, Susan Furth
Chronic kidney disease (CKD) has become a significant public health concern, as it is associated with substantial morbidity. Prior research has evaluated multiple novel CKD biomarkers to supplement serum creatinine and proteinuria. The ultimate goal of this research is to find biomarkers that can be used to accurately predict CKD progression and to better time outpatient follow-up, and referral for transplant. Also, an optimal panel of biomarkers can augment the predictive value of proteinuria and serum creatinine by enriching patient enrollment in clinical trials...
June 17, 2017: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
https://www.readbyqxmd.com/read/28621637/surgical-techniques-and-procedures-for-kidney-transplant-recipients-with-severe-atherosclerosis
#13
Koji Nanmoku, Yoshihiko Watarai, Shunji Narumi, Norihiko Goto, Takayuki Yamamoto, Makoto Tsujita, Takahisa Hiramitsu, Akio Katayama, Takaaki Kobayashi, Kazuharu Uchida
OBJECTIVES: Atherosclerosis is becoming a more common problem for dialysis patients. Therefore, transplant surgeons are faced with the need to develop surgical techniques and procedures for severe atherosclerosis. This study aimed to clarify the clinical features, the usefulness of examinations, and operative procedures for kidney transplant recipients with the complication of severe atherosclerosis. MATERIALS AND METHODS: Among 220 kidney transplant candidates, 13 patients (severe atherosclerosis group) were predicted complications due to arterial calcification in the bilateral iliac arterial system using a computed tomographic scan...
June 16, 2017: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/28611860/renal-function-and-outcomes-with-use-of-left-ventricular-assist-device-implantation-and-inotropes-in-end-stage-heart-failure-a-retrospective-single-center-study
#14
Sean Verma, Emmanuel Bassily, Shane Leighton, Rahul Mhaskar, Igor Sunjic, Angel Martin, Nancy Rihana, Tambi Jarmi, Claude Bassil
BACKGROUND: Left ventricular assist device (LVAD) and inotrope therapy serve as a bridge to transplant (BTT) or as destination therapy in patients who are not heart transplant candidates. End-stage heart failure patients often have impaired renal function, and renal outcomes after LVAD therapy versus inotrope therapy have not been evaluated. METHODS: In this study, 169 patients with continuous flow LVAD therapy and 20 patients with continuous intravenous inotrope therapy were analyzed...
July 2017: Journal of Clinical Medicine Research
https://www.readbyqxmd.com/read/28597555/harnessing-scientific-and-technological-advances-to-improve-equity-in-kidney-allocation-policies
#15
Anat R Tambur, Benoit Audry, Corinne Antoine, Caroline Suberbielle, Denis Glotz, Christian Jacquelinet
We reported that current assignment of HLA-DQ is a barrier to organ allocation. Here we simulated the impact of incorporating HLA-DQ antigens and antibodies as A/B and αβ allelic variants, respectively, on calculated PRA and probability of finding potential compatible donors (PCD). A cohort of 1224 donors and 2075 sensitized candidates was analyzed using HLA-DQαβ allelic (study) versus serologic (current practice) nomenclature. A significant (p<10(-4) ) decrease in cPRA was observed with higher impact for male versus female, and first transplant versus retransplant (p<10(-4) ), affecting mostly patients with moderate cPRA (30-80%)...
June 8, 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/28596416/a-kidney-graft-survival-calculator-that-accounts-for-mismatches-in-age-sex-hla-and-body-size
#16
Valarie B Ashby, Alan B Leichtman, Michael A Rees, Peter X-K Song, Mathieu Bray, Wen Wang, John D Kalbfleisch
BACKGROUND AND OBJECTIVES: Outcomes for transplants from living unrelated donors are of particular interest in kidney paired donation (KPD) programs where exchanges can be arranged between incompatible donor-recipient pairs or chains created from nondirected/altruistic donors. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: Using Scientific Registry of Transplant Recipients data, we analyzed 232,705 recipients of kidney-alone transplants from 1998 to 2012. Graft failure rates were estimated using Cox models for recipients of kidney transplants from living unrelated, living related, and deceased donors...
July 7, 2017: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/28583564/recognition-of-kidney-donation-by-living-kidney-donors-that-accompanies-changes-in-the-recipients-physical-condition-focusing%C3%A2-on-its-influences-on-donors
#17
Y Takada
INTRODUCTION: In 2013, a total of 1586 kidney transplants were performed in Japan, and 1431 (90.2%) of the organs were from living donors. The purpose of this study is to illuminate the awareness of living kidney donors toward kidney donation after the condition of the recipient changed, thus clarifying the influence of that recognition on the donor. METHODS: This study design was qualitative descriptive research. Transplant coordinators at 4 hospitals were commissioned to screen subject candidates and hand-deliver printed research explanations to them...
June 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28576438/increase-of-allosensitization-after-a-kidney-graft-failure-predictors-and-effect-on-retransplantation-outcomes
#18
Andreia Campos, Jorge Malheiro, Sandra Tafulo, Sofia Santos, Leonídeo Dias, La Salete Martins, Manuela Almeida, Sofia Pedroso, A Castro Henriques, António Cabrita
Patients who are candidates for a second kidney transplant (SKT) frequently have a higher level of panel reactive antibodies (PRA). We assessed the allosensitisation change after a first graft failure (GF), its predictors and impact on retransplantat outcomes. We retrospectively selected 140 adult patients who received a SKT. Recipient and donor characteristics were analyzed. We defined the delta PRA (dPRA) as the difference between peak PRA before the SKT and first one (cohort median value=+10%). Logistic regression analysis was used to determine risk factors for dPRA≥10% and acute rejection (AR) in the SKT...
May 30, 2017: Nefrología: Publicación Oficial de la Sociedad Española Nefrologia
https://www.readbyqxmd.com/read/28564126/prehabilitation-for-kidney-transplant-candidates-is-it-time
#19
REVIEW
Xingxing S Cheng, Jonathan N Myers, Glenn M Chertow, Ralph Rabkin, Khin N Chan, Yu Chen, Jane C Tan
Many patients become frail with diminished cardiorespiratory fitness while awaiting kidney transplantation. Frailty and poor fitness powerfully predict mortality, transplant graft survival, and health care utilization after kidney transplantation. Efforts to intervene with post-transplant physical therapy have been met with limited success, in large part due to high study drop-out. We reviewed the literature on chronic kidney disease and exercise to propose a clinical framework for physical therapy interventions to improve fitness, scheduled for before the transplant...
May 31, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/28557957/plasma-exosomes-from-hla-sensitized-kidney-transplant-recipients-contain-mrna-transcripts-which-predict-development-of-antibody-mediated-rejection
#20
Hao Zhang, Edmund Huang, Joseph Kahwaji, Cynthia C Nast, Ping Li, James Mirocha, David L Thomas, Shili Ge, Ashley A Vo, Stanley C Jordan, Mieko Toyoda
BACKGROUND: Sensitization to human leukocyte antigens (HLA) remains a significant immunologic barrier to successful transplantation. Identifying immune mechanisms responsible for antibody-mediated rejection (ABMR) is an important goal. Here we explored the possibility of predicting the risk for ABMR by measuring mRNA transcripts of ABMR-associated genes in plasma exosomes from kidney transplant patients. METHODS: Total RNA was extracted from exosomes purified from 152 EDTA-plasma samples of 64 patients (18 ABMR, 8 cell-mediated rejection [CMR], 38 no rejection in desensitized (DES) and non-desensitized (non-DES) control groups) for reverse transcription into cDNA, preamplification and then real time quantitative polymerase chain reaction (qPCR) for 21 candidate genes...
May 27, 2017: Transplantation
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