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Kidney transplant candidate

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https://www.readbyqxmd.com/read/29215463/variation-in-practice-patterns-for-listing-patients-for-renal-transplantation-in-the-united-kingdom-a-national-survey
#1
Rishi Pruthi, Sarah Tonkin-Crine, Melania Calestani, Geraldine Leydon, Caroline Eyles, Gabriel C Oniscu, Charles Tomson, Andrew Bradley, John L Forsythe, Clare Bradley, John Cairns, Christopher Dudley, Christopher Watson, Heather Draper, Rachel Johnson, Wendy Metcalfe, Damian Fogarty, Rommel Ravanan, Paul J Roderick
INTRODUCTION: Despite the availability of guidelines for the evaluation of candidates for renal transplantation, variation in access to transplantation exists. This national survey investigates whether centre variation exists in the assessment of patients for renal transplantation in the UK. METHODS: An online survey, informed by qualitative interviews, was distributed to all UK renal centres. This survey examined centre approaches to chronic kidney disease service provision, transplant recipient assessment, education provision and wait-listing decision making processes...
December 5, 2017: Transplantation
https://www.readbyqxmd.com/read/29199277/the-renaissance-of-complement-therapeutics
#2
REVIEW
Daniel Ricklin, Dimitrios C Mastellos, Edimara S Reis, John D Lambris
The increasing number of clinical conditions that involve a pathological contribution from the complement system - many of which affect the kidneys - has spurred a regained interest in therapeutic options to modulate this host defence pathway. Molecular insight, technological advances, and the first decade of clinical experience with the complement-specific drug eculizumab, have contributed to a growing confidence in therapeutic complement inhibition. More than 20 candidate drugs that target various stages of the complement cascade are currently being evaluated in clinical trials, and additional agents are in preclinical development...
December 4, 2017: Nature Reviews. Nephrology
https://www.readbyqxmd.com/read/29198669/broadened-allocation-of-pancreas-transplants-across-compatible-abo-blood-types
#3
J A Fridell, S K Gustafson, B W Thompson, A C Fox, M A Prentice, M A Curry, J S Odorico
BACKGROUND: Current Organ Procurement and Transplantation Network (OPTN) policy restricts certain blood type-compatible simultaneous pancreas and kidney (SPK) transplants. Using the Kidney Pancreas Simulated Allocation Model, we examined the effects of 5 alternative allocation sequences that allowed all clinically compatible ABO transplants. METHODS: The study cohort included kidney (KI), SPK, and pancreas alone (PA) candidates waiting for transplant for at least 1 day between January 1, 2010, and December 31, 2010 (full cohort), and kidneys and pancreata recovered for transplant during the same period...
December 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/29176362/significance-of-biologics-in-renal-transplantation-past-present-and-future
#4
Ivica Grgic, Anil Chandraker
PURPOSE OF REVIEW: Finding the right immunosuppressive approach for the individual transplant patient is of utmost importance. In truth, a 'one size fits all' does not exist, and as patients differ, so should therapeutic suppression of the immune system be individualized. For over three decades, biologics have been a central component of transplant immunosuppression. Our growing knowledge of immunological processes combined with biotechnological advances is leading to promising new therapeutic concepts and possibilities including novel biologics...
November 25, 2017: Current Opinion in Organ Transplantation
https://www.readbyqxmd.com/read/29173815/-focusing-on-kidney-transplantation-in-the-elderly
#5
Mathilde Lemoine, Dominique Guerrot, Dominique Bertrand
Due to the increase in life expectancy and the ageing of end-stage renal disease patients, the number of patients older than 65 years receiving a kidney transplant has been continuously growing over the last fifteen years. The benefits of renal transplantation compared to dialysis in terms of survival and quality of life have been shown in selected recipients over 65, or 70 years. However, the age remains the main limiting factor for the access to the waiting list, and the reluctance of the clinicians can be explained by the multiple comorbidities of these candidates, their limited life expectancy or the shortage of grafts...
November 21, 2017: Néphrologie & Thérapeutique
https://www.readbyqxmd.com/read/29169444/urinary-diversion-in-renal-transplantation
#6
REVIEW
Mohamed Eltemamy, Alice Crane, David A Goldfarb
Renal transplantation involving anatomically or functionally altered recipient urinary reservoirs is a challenging procedure. Initial reports discouraged kidney transplantation in patients with urinary diversion due to inferior outcomes. However, more recent studies have shown that although there are more infectious complications, patients with urinary diversions have comparable long-term graft survival with those with native anatomy. Careful preoperative assessment of these candidates is mandatory. Unique technical and surgical concepts must be considered before embarking on transplanting this specific cohort of kidney transplantation candidates...
February 2018: Urologic Clinics of North America
https://www.readbyqxmd.com/read/29159472/current-strategies-to-predict-and-manage-sequelae-of-posterior-urethral-valves-in-children
#7
Aniruddh V Deshpande
Posterior urethral valves (PUV) constitute a significant urological cause of chronic kidney disease (CKD) in children. The condition is characterised by the unique pathophysiology of the evolution of bladder dysfunction after relief of obstruction, which contributes to CKD. Improvements in prenatal diagnosis followed by selective foetal intervention have not yet produced improvement in long-term renal outcomes, although better patient selection may alter this in the future. Proactive management with surveillance, pharmacotherapy, timed voiding, double voiding, and/or assisted bladder-emptying, is being increasingly offered to those with severe bladder dysfunction and has the potential of reducing the burden of renal disease...
November 20, 2017: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
https://www.readbyqxmd.com/read/29149954/preoperative-risk-factors-associated-with-urinary-complications-after-kidney-transplantation
#8
T Bessede, Y Hammoudi, D Bedretdinova, B Parier, H Francois, A Durrbach, G Benoit
BACKGROUND: Only surgically irrelevant risk factors including sex, African-American ancestry, or exceptional U-stitch anastomosis have been identified to associate with urinary complications after kidney transplantation. The objective was to identify modifiable and nonmodifiable risk factors associated with urinary complications after kidney transplantation. METHODS: A single-center study of 3,129 kidney transplants performed over 40 years was conducted to identify independent risk factors using χ(2) tests and logistic regression analysis...
November 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/29145879/allogeneic-mesenchymal-stem-cell-as-induction-therapy-to-prevent-both-delayed-graft-function-and-acute-rejection-in-deceased-donor-renal-transplantation-study-protocol-for-a-randomized-controlled-trial
#9
Qipeng Sun, Liangqing Hong, Zhengyu Huang, Ning Na, Xuefeng Hua, Yanwen Peng, Ming Zhao, Ronghua Cao, Qiquan Sun
BACKGROUND: Using kidneys from deceased donors is an available strategy to meet the growing need of grafts. However, higher incidences of delayed graft function (DGF) and acute rejection exert adverse effects on graft outcomes. Since ischemia-reperfusion injury (IRI) and ongoing process of immune response to grafts are the major causes of DGF and acute rejection, the optimal induction intervention should possess capacities of both repairing renal structure injury and suppressing immune response simultaneously...
November 16, 2017: Trials
https://www.readbyqxmd.com/read/29140548/a-phase-ib-open-label-single-arm-study-to-assess-the-safety-pharmacokinetics-and-impact-on-humoral-sensitization-of-sanguinate-infusion-in-patients-with-end-stage-renal-disease
#10
Bassam G Abu Jawdeh, E Steve Woodle, Abbie D Leino, Paul Brailey, Simon Tremblay, Tonya Dorst, Mouhamad H Abdallah, Amit Govil, Daniel Byczkowski, Hemant Misra, Abraham Abuchowski, Rita R Alloway
The endeavor to study desensitization in kidney transplantation hasn't been matched by an effort to investigate strategies to prevent sensitization. In this study (NCT02437422), we investigated the safety, impact on sensitization and pharmacokinetics of SANGUINATE (SG), a hemoglobin-based oxygen carrier, as a potential alternative to packed red blood cells (PRBC) in transplant candidates with end-stage renal disease (ESRD). Ten ESRD subjects meeting inclusion/exclusion (I/E) criteria were planned to receive 3 weekly infusions of SG (320mg/Kg)...
November 15, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/29137893/advances-in-the-evaluation-of-bone-health-in-kidney-transplant-patients
#11
María José Pérez-Sáez, Daniel Prieto-Alhambra, Adolfo Díez-Pérez, Julio Pascual
Bone disease related to chronic kidney disease and, particularly, to kidney transplant patients is a common cause or morbidity and mortality, especially due to a higher risk of osteoporotic fractures. Despite the fact that this has been known for decades, to date, an appropriate diagnostic strategy has yet to be established. Apart from bone biopsy, which is invasive and scarcely used, no other technique is available to accurately establish the risk of fracture in kidney patients. Techniques applied to the general population, such as bone densitometry, have not been subjected to sufficient external validation and their use is not systematic...
November 11, 2017: Nefrología: Publicación Oficial de la Sociedad Española Nefrologia
https://www.readbyqxmd.com/read/29127259/whole-exome-sequencing-of-patients-with-steroid-resistant-nephrotic-syndrome
#12
Jillian K Warejko, Weizhen Tan, Ankana Daga, David Schapiro, Jennifer A Lawson, Shirlee Shril, Svjetlana Lovric, Shazia Ashraf, Jia Rao, Tobias Hermle, Tilman Jobst-Schwan, Eugen Widmeier, Amar J Majmundar, Ronen Schneider, Heon Yung Gee, J Magdalena Schmidt, Asaf Vivante, Amelie T van der Ven, Hadas Ityel, Jing Chen, Carolin E Sadowski, Stefan Kohl, Werner L Pabst, Makiko Nakayama, Michael J G Somers, Nancy M Rodig, Ghaleb Daouk, Michelle Baum, Deborah R Stein, Michael A Ferguson, Avram Z Traum, Neveen A Soliman, Jameela A Kari, Sherif El Desoky, Hanan Fathy, Martin Zenker, Sevcan A Bakkaloglu, Dominik Müller, Aytul Noyan, Fatih Ozaltin, Melissa A Cadnapaphornchai, Seema Hashmi, Jeffrey Hopcian, Jeffrey B Kopp, Nadine Benador, Detlef Bockenhauer, Radovan Bogdanovic, Nataša Stajić, Gil Chernin, Robert Ettenger, Henry Fehrenbach, Markus Kemper, Reyner Loza Munarriz, Ludmila Podracka, Rainer Büscher, Erkin Serdaroglu, Velibor Tasic, Shrikant Mane, Richard P Lifton, Daniela A Braun, Friedhelm Hildebrandt
BACKGROUND AND OBJECTIVES: Steroid-resistant nephrotic syndrome overwhelmingly progresses to ESRD. More than 30 monogenic genes have been identified to cause steroid-resistant nephrotic syndrome. We previously detected causative mutations using targeted panel sequencing in 30% of patients with steroid-resistant nephrotic syndrome. Panel sequencing has a number of limitations when compared with whole exome sequencing. We employed whole exome sequencing to detect monogenic causes of steroid-resistant nephrotic syndrome in an international cohort of 300 families...
November 10, 2017: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/29116674/turn-down-for-what-patient-outcomes-associated-with-declining-increased-infectious-risk-kidneys
#13
Mary G Bowring, Courtenay M Holscher, Sheng Zhou, Allan B Massie, Jacqueline Garonzik-Wang, Lauren M Kucirka, Sommer E Gentry, Dorry L Segev
Transplant candidates who accept a kidney labeled increased risk for disease transmission (IRD) accept a low risk of window period infection, yet those who decline must wait for another offer that might harbor other risks or never even come. To characterize survival benefit of accepting IRD kidneys, we used 2010-2014 SRTR data to identify 104,998 adult transplant candidates who were offered IRD kidneys that were eventually accepted by someone; the median (IQR) KDPI of these kidneys was 30 (16-49). We followed patients from the offer decision until death or end-of-study...
November 8, 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/29108509/smoking-history-is-associated-with-adverse-outcomes-for-kidney-allograft-recipients
#14
Holly Gillott, Francesca Jackson Spence, Sanna Tahir, Jemma Mytton, Felicity Evison, Jay Nath, Adnan Sharif
OBJECTIVES: How smoking history affects kidney allograft outcomes is unclear in the contemporary era of immunosuppression. Here, we examined a broad range of outcomes after kidney transplant, stratifying patients by smoking status documented at time of transplant, in a well-characterized clinical cohort. MATERIALS AND METHODS: This retrospective single-center analysis (2007-2015) included 744 kidney allograft recipients who had documentation of smoking exposure (median follow-up 1327 days posttransplant)...
October 31, 2017: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/29105843/the-liver-recipient-with-acute-renal-dysfunction-a-single-institution-evaluation-of-the-simultaneous-liver-kidney-transplant-candidate
#15
Kunal Yadav, Oscar K Serrano, Kent J Peterson, Timothy L Pruett, Raja Kandaswamy, Ananta Bangdiwala, Hassan Ibrahim, Ajay Israni, John Lake, Srinath Chinnakotla
The Organ Procurement Transplant Network (OPTN) listing criteria for simultaneous liver-kidney transplant (SLK) are not well defined. Concerns remain about rising numbers of SLKs, which divert quality kidneys from candidates awaiting kidney transplants (KT). We performed a retrospective review of liver transplants (LT) at our center from 2004-14; 127 recipients (Liver transplant alone; 102 LTA, 25 SLK) were identified with short-term preoperative kidney dysfunction (creatinine >4 mg/dL or preoperative hemodialysis [HD] for <6 wks)...
November 4, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/29100996/should-living-donor-liver-transplantation-be-an-option-when-deceased-donation-is-not
#16
Sarah R Lieber, Thomas D Schiano, Rosamond Rhodes
When a liver transplantation candidate is declined for listing to receive a deceased organ, sometimes a loved one comes forward and offers to be a living donor. This raises the ethical question of whether a patient who is not eligible for deceased donor liver transplantation should be eligible for living donor liver transplantation. We compare living organ donation in kidney and liver transplantation and explore key ethical concepts of justice, fairness, and societal trust. Ultimately, because there is no alternative life-preserving therapy in end-stage liver disease, and because transplantation with a living donor organ does not involve removing a resource from the common pool of transplant organs, we argue that a "slightly less benefit" than what is required for deceased transplantation listing standard should be used to determine the acceptability of living donor liver transplantation...
October 31, 2017: Journal of Hepatology
https://www.readbyqxmd.com/read/29093653/comparison-of-the-commercial-quantiferon-cmv-and-overlapping-peptide-based-elispot-assays-for-predicting-cmv-infection-in-kidney-transplant-recipients
#17
Ji-Soo Kwon, Taeeun Kim, Sun-Mi Kim, Heungsup Sung, Sung Shin, Young Hoon Kim, Eui-Cheol Shin, Sung-Han Kim, Duck Jong Han
Cytomegalovirus (CMV) is one of the most important opportunistic infections in transplant recipients. Tests for CMV-specific T cell responses have been proposed to change the current risk stratification strategy using CMV assays. We evaluated the usefulness of pre-transplant CMV-specific T cell assays in kidney transplant (KT) candidates for predicting the development of CMV infection after transplantation comparing the results of the overlapping peptides (OLPs)-based enzyme-linked immunospot (ELISPOT) assay and the commercial QuantiFERON-CMV assay...
October 2017: Immune Network
https://www.readbyqxmd.com/read/29077659/baseline-and-center-level-variation-in-simultaneous-liver-kidney-listing-in-the-united-states
#18
Xun Luo, Allan B Massie, Christine E Haugen, Rashikh Choudhury, Jessica M Ruck, Ashton A Shaffer, Sheng Zhou, Dorry L Segev, Jacqueline M Garonzik-Wang
BACKGROUND: The OPTN has implemented medical criteria to determine which candidates are most appropriate for simultaneous liver-kidney transplantation (SLK) in comparison to liver-alone transplantation. We investigated prepolicy center-level variation among SLK-listing practice, in light of such criteria. METHODS: We identified 4,736 SLK-eligible candidates after Share-35 in the U.S. We calculated the proportion of candidates at each center who were listed for SLK within 6 months of eligibility...
October 26, 2017: Transplantation
https://www.readbyqxmd.com/read/29055420/expanding-the-use-of-hepatitis-c-viremic-kidney-donors
#19
Deirdre Sawinski, Christina M Wyatt, Jayme E Locke
Direct-acting antivirals have revolutionized the treatment of hepatitis C virus (HCV) infection in patients with chronic kidney disease, with implications for the timing of antiviral treatment among kidney transplant candidates and for the use of HCV viremic donors. A recent consensus conference reviewed the available data on the safety and cost-effectiveness of expanding access to HCV-positive organs to HCV-negative recipients. Early trials are promising, but larger trials and a plan for obtaining HCV therapy in the posttransplantation period are needed...
November 2017: Kidney International
https://www.readbyqxmd.com/read/29052563/predictive-score-model-for-delayed-graft-function-based-on-easily-available-variables-before-kidney-donation-after-cardiac-death
#20
Chen-Guang Ding, Qian-Hui Tai, Feng Han, Yang Li, Xiao-Hui Tian, Pu-Xun Tian, Xiao-Ming Ding, Xiao-Ming Pan, Jin Zheng, He-Li Xiang, Wu-Jun Xue
BACKGROUND: How to evaluate the quality of donation after cardiac death (DCD) kidneys has become a critical problem in kidney transplantation in China. Hence, the aim of this study was to develop a simple donor risk score model to evaluate the quality of DCD kidneys before DCD. METHODS: A total of 543 qualified kidneys were randomized in a 2:1 manner to create the development and validation cohorts. The donor variables in the development cohort were considered as candidate univariate predictors of delayed graft function (DGF)...
October 20, 2017: Chinese Medical Journal
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