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outcomes of renal transplantation

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https://www.readbyqxmd.com/read/28432714/high-human-cytomegalovirus-dnaemia-early-post-transplantation-associates-with-irreversible-and-progressive-loss-of-renal-function
#1
Wouter T Lollinga, Lilli Rurenga-Gard, Willem van Doesum, Rik van Bergen, Arjan Diepstra, Judith M Vonk, Annelies Riezebos-Brilman, Hgm Niesters, Willem J van Son, Jacob van den Born, Jan-Stephan Sanders
BACKGROUND: Transplant recipients are prone to viral infections, which could affect renal transplantation outcome. Our aim was to assess the effects of early human cytomegalovirus (CMV) DNAemia on transplant renal function. METHODS: 264 (age 50.9±13.5; male 55%) Renal transplantation recipients undergoing preemptive anti-CMV therapy were retrospectively categorized based on early (<3 months post-Tx) CMV peak viral load (PVL); PVL≤536, PVL536-6310 or PVL>6310 International Units/ml (IU/ml)...
April 22, 2017: Transplant International: Official Journal of the European Society for Organ Transplantation
https://www.readbyqxmd.com/read/28429575/recovery-from-talaromyces-marneffei-involving-the-kidney-in-a-renal-transplant-recipient-a-case-report-and-literature-review
#2
Juan Peng, Zhiyong Chen, Ruiming Cai, Xianen Huang, Liying Lin, Weixiang Liang, Zhongtang Xiong, Juan Chen, Hui Chen, Yuexin Yang, Shaoyan Liu, Qingping Jiang
Talaromyces marneffei is an emerging opportunistic infection among immunocompromised patients. We observe the first native case of disseminated T. marneffei involving the kidney in a renal transplant recipient in mainland China. We describe the comprehensive clinical course, and ultrasound imaging of renal transplant biopsy, pathologic images, and electron microscopy observation of the biopsy specimen, highlighting the relevance of biopsy findings and the blood culture. We also focus on the treatment and good outcome of the patient...
April 21, 2017: Transplant Infectious Disease: An Official Journal of the Transplantation Society
https://www.readbyqxmd.com/read/28427723/health-related-quality-of-life-in-renal-transplantation-2-years-of-longitudinal-follow-up
#3
Gema Costa-Requena, M Carmen Cantarell, Francesc Moreso, Gemma Parramon, Daniel Seron
BACKGROUND AND OBJECTIVE: Health related quality of life (HRQoL) is recognized as an outcome measure in kidney transplantation. In this study was assessed changes on HRQoL and kidney-specific symptoms, also was evaluated the effect of socio-demographic and clinical parameters on patient's perceived HRQoL. PATIENTS AND METHOD: A longitudinal study was done, at 5 time-points over 2 years after transplantation. To evaluate HRQoL the Kidney Disease Quality of Life Questionnaire Short Form was administrated, and Hospital Anxiety and Depression Scale was used to assess psychological distress...
April 17, 2017: Medicina Clínica
https://www.readbyqxmd.com/read/28427351/proteinuria-and-baseline-renal-function-predict-mortality-and-renal-outcomes-after-sirolimus-therapy-in-liver-transplantation-recipients
#4
Lung-Chih Li, Chien-Ning Hsu, Chih-Che Lin, Yu-Fan Cheng, Tsung-Hui Hu, Ding-Wei Chen, Chih-Hsiung Lee, Toshiaki Nakano, Chao-Long Chen
BACKGROUND: Chronic kidney disease is a significant complication after liver transplantation (LT), but the role of pre-existing renal insufficiency and proteinuria remains unclear among LT recipients receiving sirolimus. METHODS: We assessed the effects of proteinuria and baseline renal function on long-term renal and survival outcomes among 576 LT recipients who received SRL in a medical center between 2005 and 2014. Renal outcomes were the incidences of >50% reduction in their baseline estimated glomerular filtration rate and end stage kidney disease requiring renal replacement therapy...
April 20, 2017: BMC Gastroenterology
https://www.readbyqxmd.com/read/28425200/high-dose-calcineurin-inhibitor-free-everolimus-as-a-maintenance-regimen-for-heart-transplantation-may-be-a-risk-factor-for%C3%A2-pneumocystis-pneumonia
#5
Yu-Ning Hu, Nan-Yao Lee, Jun-Neng Roan, Chi-Hsin Hsu, Chwan-Yao Luo
BACKGROUND: Everolimus reduces the incidence of cardiac-allograft vasculopathy (CAV) and is less renally toxic than are calcineurin inhibitors (CNIs). We evaluated the safety of CNI-free everolimus for post-heart transplant (HTx) patients. METHODS: We retrospectively reviewed the records of 36 consecutive patients who had undergone an HTx between January 2006 and December 2013 in National Cheng Kung University Hospital. All patients initially had been treated with the standard tacrolimus regimen...
April 20, 2017: Transplant Infectious Disease: An Official Journal of the Transplantation Society
https://www.readbyqxmd.com/read/28425171/how-is-continuity-of-care-experienced-by-people-living-with-chronic-kidney-disease
#6
Sarah Brand, Kristian Pollock
AIMS AND OBJECTIVES: To explore patients' perceptions of continuity of care within a hospital based specialist service. BACKGROUND: Patient journeys through healthcare are becoming increasingly complex. For patients with chronic conditions, the longevity of their illness and common multiple co-morbities make this complexity more pronounced. Continuity of care is most challenging to provide for these patients. A multifaceted model of continuity is widely accepted, but despite this, much literature focuses exclusively on relational aspects...
April 20, 2017: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/28424878/oral-health-in-patients-with-renal-disease-a-longitudinal-study-from-predialysis-to-kidney-transplantation
#7
Karita M Nylund, Jukka H Meurman, Anna Maria Heikkinen, Jussi O Furuholm, Fernanda Ortiz, Hellevi M Ruokonen
OBJECTIVES: The aim of this longitudinal study was to compare the oral health of chronic kidney disease patients at the predialysis (baseline) and post-transplantation (follow-up) stages and to investigate differences in oral health between diabetic nephropathy and other kidney disease patients at follow-up. MATERIALS AND METHODS: Fifty-three kidney disease patients (34 men) aged 31-86 years were followed up to 157 months. Clinical and radiological oral examinations, salivary and laboratory analyses, and oral health behavior questionnaires were conducted at the predialysis and follow-up stages at Helsinki University Hospital, Finland...
April 20, 2017: Clinical Oral Investigations
https://www.readbyqxmd.com/read/28420067/kidney-transplantation-for-end-stage-renal-disease-in-lupus-nephritis-a-very-safe-procedure-a-single-latin-american-transplant-center-experience
#8
J Naranjo-Escobar, E Manzi, J G Posada, L Mesa, G J Echeverri, C Duran, J Schweneiberg, L A Caicedo, J I Villegas, G J Tobón
Background Lupus nephritis (LN) is one of the most frequent complications of SLE and occurs in up to 50% of cases depending on the studied population. Of these, approximately 20% progress to end-stage renal disease (ESRD), with the treatment of choice being a kidney transplant. Objective The objective of this study was to describe the clinical outcome of patients transplanted due to LN, compared with patients transplanted for other causes, in a Latin American population from the Fundación Valle del Lili in Cali, Colombia...
January 1, 2017: Lupus
https://www.readbyqxmd.com/read/28415773/effects-of-cd20-b-cell-infiltration-into-allografts-on-kidney-transplantation-outcomes-a-systematic-review-and-meta-analysis
#9
REVIEW
Yingying Lu, Bingjue Li, Qixia Shen, Rending Wang, Zhimin Chen, Hong Jiang, Jianghua Chen
The effects of CD20+ B-cell infiltration during acute rejection on graft outcomes are controversial. The objective of this systematic review and meta-analysis was to clarify this issue. We performed a systematic literature search for studies published up to January 14, 2016. A total of 5 studies, with 200 patients, were included. The presence of CD20+ B cells in renal biopsies during allograft rejection was associated with graft loss and steroid resistance. No association of CD20+ B-cell infiltration with C4d-positive staining of the peritubular capillaries in renal biopsies was found in the analysis of patients who experienced kidney graft rejection...
March 15, 2017: Oncotarget
https://www.readbyqxmd.com/read/28411866/addressing-the-challenges-of-sleeve-gastrectomy-in-end-stage-renal-disease-analysis-of-100-consecutive-renal-failure-patients
#10
Young Kim, Junzi Shi, Christopher M Freeman, Andrew D Jung, Vikrom K Dhar, Shimul A Shah, E Steve Woodle, Tayyab S Diwan
BACKGROUND: While previous studies have demonstrated short-term efficacy of laparoscopic sleeve gastrectomy in candidates awaiting renal transplantation, the combination of morbid obesity and end-stage renal disease presents unique challenges to perioperative care. We demonstrate how increasing experience and the development of postoperative care guidelines can improve outcomes in this high-risk population. METHODS: Single-center medical records were reviewed for renal transplantation candidates undergoing laparoscopic sleeve gastrectomy between 2011 and 2015 by a single surgeon...
April 12, 2017: Surgery
https://www.readbyqxmd.com/read/28411357/kidney-transplant-from-a-deceased-donor-with-renal-artery-aneurysm-a-case-report
#11
Alireza Shamsaeefar, Saman Nikeghbalian, Kourosh Kazemi, Mohsenreza Mansorian, Nasrin Motazedian, Seyed Ali Malekhosseini
The use of marginal kidneys or kidneys with pathologic problems (such as renal artery aneurysms in a living or deceased donor) is on the rise due to organ shortages and improvements in surgical techniques. When renal vascular abnormalities are detected during a transplant, it puts the surgeon in a difficult position to decide what to do with the organ. In this study, we report a case of a kidney from a deceased donor who had 2 renal artery saccular aneurysms, which we were able to use for transplant. The recipient was a 61-year-old male patient with diabetic nephropathy and significant comorbidities...
April 14, 2017: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/28410647/disease-trajectories-before-esrd-implications-for-clinical-management
#12
REVIEW
Keiichi Sumida, Csaba P Kovesdy
One of the biggest challenges nephrologists face is to predict complex clinical pathways of kidney disease progression that do not follow a steady linear decline. This unpredictability often becomes a barrier to timely shared decision making between patients and physicians and could lead to adverse patient outcomes. By using numerous analytic approaches to characterize the longitudinal changes in kidney function, emerging evidence has disclosed the heterogeneous trajectories of kidney disease progression, particularly in late-stage chronic kidney disease (CKD) nearing end-stage renal disease (ESRD), and showed their independent associations with various clinical outcomes...
March 2017: Seminars in Nephrology
https://www.readbyqxmd.com/read/28408734/mycophenolate-mofetil-and-pulmonary-fibrosis-after-kidney-transplantation-a-case-report
#13
Kazuhiro Takahashi, Pauline Go, Chad H Stone, Mohamed Safwan, Krishna G Putchakayala, William J Kane, Lauren E Malinzak, Dean Y Kim, Jason E Denny
BACKGROUND Mycophenolate mofetil (MMF) induced lung disease has been described in only a few isolated reports. We report a case of fatal respiratory failure associated with MMF after kidney transplantation. CASE REPORT A 50-year-old Hispanic male with a history of end-stage renal disease secondary to hypertension underwent deceased donor kidney transplantation. His preoperative evaluations were normal except for a chest x-ray which showed bilateral interstitial opacities. Tacrolimus and MMF were started on the day of surgery...
April 14, 2017: American Journal of Case Reports
https://www.readbyqxmd.com/read/28406085/a-single-center-kidney-transplant-experience-among-ten-caucasian-females-with-end-stage-renal-disease-due-to-scleroderma%C3%A2
#14
Nishkarsh Saxena, Arjang Djamali, Brad C Astor, Maha Mohamed, Didier Mandelbrot, Sandesh Parajuli
There is limited information on kidney transplant recipients with end-stage renal disease (ESRD) due to scleroderma. We conducted an observational study on kidney transplant recipients with ESRD due to scleroderma who received kidney transplant at our center between 01/1994 and 06/2013. During the study period, there were 10 kidney transplant recipients, all of whom were Caucasian females. Seven of them were living-donor kidney transplant recipients, and the mean age at time of transplant was 56.6 ± 11.99 years...
April 13, 2017: Clinical Nephrology
https://www.readbyqxmd.com/read/28405599/absence-of-intragraft-b-cells-in-rejection-biopsies-after-rituximab-induction-therapy-consequences-for-clinical-outcome
#15
Martijn W F van den Hoogen, Eric J Steenbergen, Marije C Baas, Sandrine Florquin, Luuk B Hilbrands
BACKGROUND: The pathophysiological role of intragraft B cells during renal allograft rejection is unclear. METHODS: We studied B-cell infiltration during acute rejection in 53 patients who participated in a clinical trial in which adult renal transplant patients were randomized between a single intraoperative dose of rituximab (375 mg/m(2)) or placebo as induction therapy. Two independent pathologists scored all biopsies in a blinded fashion according to the Banff classification and scored for the presence of B cells and plasma cells using CD79a and CD138 as markers...
April 2017: Transplantation Direct
https://www.readbyqxmd.com/read/28401625/fatal-case-of-cutaneous-sparing-oro-laryngeal-zoster-in-a-renal-transplant-recipient
#16
Elie Helou, Matthew Grant, Marie Landry, Xinyu Wu, Jon S Morrow, Maricar F Malinis
Herpesvirus infections in solid organ transplant (SOT) recipients are a significant cause of morbidity and mortality. We report a case of herpes zoster (HZ) in a kidney transplant recipient while receiving belatacept, a CTLA-4 inhibitor that prevents acute rejection. The patient presented with oropharyngolaryngeal mucosal lesions that subsequently disseminated resulting in pneumonitis and meningo-encephalitis. Very late-onset HZ can occur and can present atypically in SOT recipients. Delayed recognition and treatment may result in poor outcomes, as illustrated by this case...
April 12, 2017: Transplant Infectious Disease: An Official Journal of the Transplantation Society
https://www.readbyqxmd.com/read/28400684/early-prediction-of-3-month-survival-of-patients-in-refractory-cardiogenic-shock-and-cardiac-arrest-on-extracorporeal-life-support
#17
Clément Delmas, Jean-Marie Conil, Simon Sztajnic, Bernard Georges, Caroline Biendel, Camille Dambrin, Michel Galinier, Vincent Minville, Olivier Fourcade, Stein Silva, Bertrand Marcheix
BACKGROUND: Extracorporeal life support (ECLS) holds the promise of significant improvement of the survival of patient in refractory cardiogenic shock (CS) or cardiac arrest (CA). Nevertheless, it remains to be shown to which extent these highly invasive supportive techniques could improve long-term patient's outcome. METHODS: The outcomes of 82 adult ECLS patients at our institution between January 2012 and December 2013 were retrospectively analyzed. RESULTS: Patients were essentially men (64...
March 2017: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/28398965/a-novel-approach-in-combined-liver-and-kidney-transplantation-with-long-term-outcomes
#18
Burcin Ekser, Richard S Mangus, W Fridell, Chandrashekhar A Kubal, Shunji Nagai, Sandra B Kinsella, Demetria R Bayt, Teresa M Bell, John A Powelson, William C Goggins, A Joseph Tector
OBJECTIVE: The aim of this study was to compare the outcomes of simultaneous and delayed implantation of kidney grafts in combined liver-kidney transplantation (CLKT). BACKGROUND DATA: Delayed function of the renal graft (DGF), which can result from hypotension and pressor use related to the liver transplantation (LT), may cause worse outcomes in CLKT. METHODS: A total of 130 CLKTs were performed at Indiana University between 2002 and 2015 and studied in an observational cohort study...
May 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28396719/case-of-hepatocellular-carcinoma-in-a-patient-with-hereditary-tyrosinemia-in-the-post-newborn-screening-era
#19
Essam M Imseis, John S Bynon, Chad Thornhill
Hereditary tyrosinemia type 1 (HT-1) is a metabolic disorder caused by a defect in tyrosine degradation. Without treatment, symptoms of hepatomegaly, renal tubular dysfunction, growth failure, neurologic crises resembling porphyrias, rickets and possible hepatocellular carcinoma can develop. The use of 2-(2-nitro-4-trifluoromethylbenzoyl)-1,3-cyclohexanedione and early diagnosis through newborn screening initiatives have resulted in a sharp decline in morbidity and mortality associated with this disease. We present a case report of a 7-year-old patient with HT-1 who was born prior to the addition of tyrosinemia to the newborn screening in her birth area...
March 28, 2017: World Journal of Hepatology
https://www.readbyqxmd.com/read/28396162/phase-i-study-of-clofarabine-and-2-gy-total-body-irradiation-as-a-non-myeloablative-preparative-regimen-for-hematopoietic-stem-cell-transplantation-hsct-in-pediatric-patients-with-hematologic-malignancies-a-therapeutic-advances-in-childhood-leukemia-tacl-consortium
#20
Sandeep Soni, Hisham Abdel-Azim, Meghann McManus, Eneida Nemecek, Richard Sposto, Ann Woolfrey, Haydar Frangoul
Clofarabine is a purine nucleoside analog with immunosuppressive and anti-leukemic activity and its inclusion in reduced intensity regimens could potentially improve outcomes. We performed a prospective Phase I study of clofarabine combined with 2 Gy total body irradiation (TBI) as a non-myeloablative (NMA) preparative regimen for allogeneic stem cell transplantation in pediatric patients, who were considered at high risk of mortality from standard myeloablative regimens. The main goal of the study was to delineate the maximum feasible dose (MFD) of clofarabine in combination with 2 Gy TBI...
April 7, 2017: Biology of Blood and Marrow Transplantation
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