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Renal transplant

Lívia Falcão Lima, Bruna Cristina Cardoso Martins, Francisco Roberto Pereira de Oliveira, Rafaela Michele de Andrade Cavalcante, Vanessa Pinto Magalhães, Paulo Yuri Milen Firmino, Liana Silveira Adriano, Adriano Monteiro da Silva, Maria Jose Nascimento Flor, Eugenie Desirée Rabelo Néri
Objective: To describe and analyze the pharmaceutical orientation given at hospital discharge of transplant patients. Methods: This was a cross-sectional, descriptive and retrospective study that used records of orientation given by the clinical pharmacist in the inpatients unit of the Kidney and Liver Transplant Department, at Hospital Universitário Walter Cantídio, in the city of Fortaleza (CE), Brazil, from January to July, 2014. The following variables recorded at the Clinical Pharmacy Database were analyzed according to their significance and clinical outcomes: pharmaceutical orientation at hospital discharge, drug-related problems and negative outcomes associated with medication, and pharmaceutical interventions performed...
July 2016: Einstein
Paolo Angeli, Dimitri Bezinover, Gianni Biancofiore, Anja Bienholz, James Findlay, Catherine Paugam Burtz, Koen Reyntjens, Tetsuro Sakai, Fuat H Saner, Dana Tomescu, Gebhard Wagener, Emmanuel Weiss
Acute kidney injury (AKI) is associated with high perioperative mortality. A series of AKI research breakthroughs are worth mentioning. First, in 2003, serum and urine biomarkers specific to AKI were identified. These biomarkers have contributed to early detection, prevention, and treatment of AKI. In 2004, AKI severity was defined with the Risk, Injury, Failure, Loss, and End-stage kidney disease (RIFLE) criteria, which was developed by the International Consensus Conference Workgroup of the Acute Dialysis Quality Initiative...
October 19, 2016: Minerva Anestesiologica
Arvind U Gowda, Colton H L McNichols, Ishan Asokan, Jamil A Matthews, E Bryan Buckingham, Jennifer Sabino, John S Maddox, Sheri Slezak, Yvonne Rasko, Devinder P Singh
PURPOSE: The purpose of this study was to compare clinical outcomes of incisional hernia repair in solid organ transplant patients using non-cross-linked porcine acellular dermal matrix (PADM), human derived acellular dermal matrix (HADM) and synthetic mesh. METHODS: A retrospective review of patients who underwent hernia repair with PADM after pancreas and/or renal transplant at the University of Maryland Medical Center from 2008 to 2012 was conducted. Repair type, postoperative infection, hernia recurrence, mesh removal, and length of follow-up were recorded...
October 17, 2016: Annals of Plastic Surgery
Jamshid Roozbeh, Leila Malekmakan, Mohammad Mostafa Harifi, Taraneh Tadayon
OBJECTIVES: Autosomal dominant polycystic kidney disease is the most common hereditary disorder resulting in end-stage renal disease that can affect other organs besides kidneys. Extrarenal involvement may increase mortality and morbidity. Approximately 50% of patients with this disorder require renal transplant. Posttransplant complications have been reported to be equal in these patients versus other recipients. We conducted this study to determine and compare characteristics and outcomes of transplanted patients with this disease versus other recipients at the only transplant center in southern Iran...
October 14, 2016: Experimental and Clinical Transplantation
G Varela-Fascinetto, C Benchimol, R Reyes-Acevedo, M Genevray, D Bradley, J Ives, H T Silva
This multicenter, open-label study evaluated the tolerability of extended prophylaxis with valganciclovir in pediatric kidney transplant recipients at risk of CMV disease. Fifty-six patients aged 4 months to 16 years received once-daily valganciclovir oral solution and/or tablets, dosed by BSA and renal function, for up to 200 days. The most common AEs on treatment were upper respiratory tract infection (33.9%), urinary tract infection (33.9%), diarrhea (32.1%), leukopenia (25.0%), neutropenia (23.2%), and headache (21...
October 17, 2016: Pediatric Transplantation
Jiang-Tao Tang, Brenda C de Winter, Dennis A Hesselink, Ferdi Sombogaard, Lan-Lan Wang, Teun van Gelder
AIM: Elderly transplant recipients have a lower incidence of acute rejection, and a higher risk to die from infectious complications. Potentially this may be caused by differences in the pharmacokinetics (PK) or pharmacodynamics (PD) of the immunosuppressive drugs they are taking. This study was designed to comprehensively evaluate the influence of age on the PK and PD of mycophenolic acid (MPA). METHODS: In this study the PK and PD of MPA was studied in 26 elderly and 54 younger renal transplant recipients treated with mycophenolate mofetil and tacrolimus...
October 18, 2016: British Journal of Clinical Pharmacology
Claudia Colomba, Marcello Trizzino, Claudia Gioè, Danilo Di Bona, Alessandra Mularoni, Antonio Cascio
Here we describe the case of a HIV-infected patient with polycystic kidney disease and end stage renal diseases not transplantable due to the persistence of a CD4 count <200 notwithstanding a good virological response to highly active antiretroviral therapy and suggest that such limitation to kidney transplantation in such as cases might be bypassed.
2016: IDCases
Afshar Zomorrodi, Shakeri Abolhassan, Abbas Jabbari, Sahar Zomorrodi, Monazzah Farzin Sheikh
Renal transplantation is the best treatment for end-stage renal disease. Vascular complications of renal transplantation can be hazardous. Bleeding from the anastomotic site in external iliac artery is a nightmare for kidney transplant surgeons. Ligation of the external iliac artery might possibly lead to the loss of the lower limbs. We present two cases of postallograft nephrectomy bleeding, in which the external iliac artery was ligated without consequent ischemia.
September 2016: Saudi Journal of Kidney Diseases and Transplantation
Sergio Mazzola Poli de Figueiredo, Andrea Olivares Magalhães, Patrícia Malafronte, José Ferraz de Souza, Yvoty Alves Santos Sens
High prevalence of hypovitaminosis D has been observed in patients with chronic kidney disease. However, there is not much data about its prevalence in kidney transplant recipients (KTRs). The study included 83 adult KTRs at a single center to calculate the prevalence of hypovitaminosis D. Among the 83 patients, those with incomplete data were excluded leaving 22 patients available for study. The demographic and biochemical data were analyzed retrospectively. Serum concentrations of 25-hydroxyvitamin D [25(OH)D], parathyroid hormone (PTH), phosphorus, calcium, and creatinine were evaluated...
September 2016: Saudi Journal of Kidney Diseases and Transplantation
Wael M Hamza, Hanan H Ali, Samia M Gabal, Sawsan A Fadda
The chronic dysfunction stands as the most common cause of renal allograft loss. During the nineties of the past century, this condition was referred to as chronic allograft nephropathy (CAN). Since 2005, CAN has been assigned by the eighth Banff schema to four main categories via histopathological and immunohistochemical findings including chronic antibodymediated rejection (CAMR), chronic T-cell-mediated rejection (CTMR), chronic cyclosporine toxicity (CNITOX), and "interstitial fibrosis (IF)/tubular atrophy; not otherwise specified (NOS)" to eliminate the term CAN...
September 2016: Saudi Journal of Kidney Diseases and Transplantation
O P Prajapati, A K Verma, R K Sharma, M Sabaretnam
We conducted a prospective study (between November 2013 and January 2015) to identify "foot at risk" in the diabetic renal transplant patients at a Tertiary Care Hospital in India. Patients (151) were divided into three groups: diabetic transplant recipients (n = 42), new onset diabetes after transplantation (NODAT) (n = 59), and controls (nondiabetic renal transplant recipients) (n = 50). Foot neuropathy and vasculopathy were assessed by standard methods. Patients with "at risk" feet were given foot care advice...
September 2016: Saudi Journal of Kidney Diseases and Transplantation
Aline Clavert, Zinaida Peric, Eolia Brissot, Florent Malard, Thierry Guillaume, Jacques Delaunay, Viviane Dubruille, Steven Le Gouill, Beatrice Mahe, Thomas Gastinne, Nicolas Blin, Jean-Luc Harousseau, Philippe Moreau, Noel Milpied, Mohamad Mohty, Patrice Chevallier
Late complications (LC) and quality of life (QOL) were analyzed in 110 adult patients who underwent reduced-intensity conditioning (RIC) allogeneic stem cell transplantation (allo-SCT) and were alive for more than two years after allo-SCT. Overall survival of these patients was 93% (95%CI, 88-99%) and 81% (95%CI, 71-94%) at 5 and ten years, respectively. The primary cause of death was a recurrence of primary malignancy. With a median follow-up of 4.6 years (range, 2-12.1), chronic graft versus host disease (cGVHD) was the most prevalent late effect with a cumulative incidence (CI) of 66% (95%CI, 57-74) at ten years...
October 14, 2016: Biology of Blood and Marrow Transplantation
Catherine Forconi, Philippe Gatault, Elodie Miquelestorena-Standley, Johan Noble, Sally Al-Hajj, Romain Guillemain, Marc Stern, Thomas Hoffmann, Louis Prat, Caroline Suberbielle, Emeline Masson, Anne Cesbron-Gautier, Catherine Gaudy-Graffin, Alain Goudeau, Gilles Thibault, Fabrice Ivanes, Roseline Guibon, Ihab Kazma, Yvon Lebranchu, Matthias Büchler, Antoine Magnan, Jean-Michel Halimi, Christophe Baron
BACKGROUND: Cytomegalovirus (CMV) has a role in chronic rejection and graft loss in kidney transplant (KTx) and lung transplant (LTx) recipients. In addition, donor CMV seropositivity is an independent risk factor for renal graft loss. The anti-CMV response might modulate this risk. Expression of programmed cell death 1 (PD-1), a receptor involved in viral-specific T-cell exhaustion, is influenced by a single nucleotide polymorphism called PD-1.3 (wild-type allele G, variant allele A)...
August 26, 2016: Journal of Heart and Lung Transplantation
Hao Yan, Wei Fang, Aiwu Lin, Liou Cao, Zhaohui Ni, Jiaqi Qian
BACKGROUND: Incident patients treated with continuous ambulatory peritoneal dialysis (CAPD) are often prescribed either 3 or 4 exchanges per day. However, the effects on residual kidney function and clinical outcomes of 3 versus 4 exchanges are not known. STUDY DESIGN: Prospective, randomized, controlled, open-label study. SETTING & PARTICIPANTS: Incident CAPD patients aged 18 to 80 years with glomerular filtration rates (GFRs; mean of renal urea and creatinine clearance from a 24-hour urine collection) ≥ 2mL/min and urine volume ≥ 500mL/d...
October 14, 2016: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
Ahmer M Hameed, Henry C Pleass, Germaine Wong, Wayne J Hawthorne
BACKGROUND: The two main options for renal allograft preservation are static cold storage (CS) and machine perfusion (MP). There has been considerably increased interest in MP preservation of kidneys, however conflicting evidence regarding its efficacy and associated costs have impacted its scale of clinical uptake. Additionally, there is no clear consensus regarding oxygenation, and hypo- or normothermia, in conjunction with MP, and its mechanisms of action are also debated. The primary aims of this article were to elucidate the benefits of MP preservation with and without oxygenation, and/or under normothermic conditions, when compared with CS prior to deceased donor kidney transplantation...
October 2016: Medicine (Baltimore)
Mapi Fleury, Caroline Fonzo-Christe, Charline Normand, Pascal Bonnabry
A heavily immunosuppressed, 43-kg, 9-year-old patient was recovering from a bone marrow transplant. Primary prophylaxis against invasive fungal infections was liposomal amphotericin B (AmBisome(®), 2.3 mg/kg [100 mg] two times per week). Once home, following a first amphotericin B infusion, he presented with strong diarrhoea and vomiting; this was repeated after the second infusion. The clinical situation worsened rapidly and the patient was rehospitalised. On admission, he presented with acute renal failure...
December 2016: Drug Saf Case Rep
Zhuo Wu, Qinxia Xu, Xiaoyan Qiu, Zheng Jiao, Ming Zhang, Mingkang Zhong
PURPOSE: The purpose of this study was to investigate the potential impact of FOXP3 and CCDC22 gene polymorphisms on efficacy and safety of tacrolimus (TAC) in renal transplant patients. METHODS: Genetic polymorphisms were detected in 114 Chinese renal transplant patients who were on TAC-based maintenance immunosuppression and were followed up for at least 2 years. The relationships between FOXP3 rs3761547, rs3761548, rs3761549, rs2232365, rs2280883, and CCDC22 rs2294021 polymorphisms and clinical outcomes such as acute rejection, TAC-induced acute nephrotoxicity, and pneumonia were investigated by using Kaplan-Meier estimates and multivariate Cox regression analysis...
October 17, 2016: European Journal of Clinical Pharmacology
S Sachin, M C Rajesh, E K Ramdas
Surgical removal of the kidney tumor outside the body, (ex vivo renal bench surgery) followed by auto transplantation is an emerging and often done procedure to reconstruct the urinary tract. It possesses immense challenges to both the anesthesiologists and the surgeons. The risks are multiplied if you are performing the surgery on a solitary functioning kidney. Here, we are describing the anesthetic management of 70-year-old male post nephrectomy patient undergoing renal auto transplantation by bench surgery...
September 2016: Anesthesia, Essays and Researches
Emmanuel Gonzales, Tim Ulinski, Dalila Habes, Georges Deschênes, Véronique Frémeaux-Bacchi, Albert Bensman
BACKGROUND: Rational options for the treatment of end-stage renal disease (ESRD) due to atypical hemolytic uremic syndrome (aHUS) in children are still open to discussion. In the case of human complement factor H (CFH) deficiency, the choice is either kidney transplantation in combination with eculizumab, a humanized anti-C5 monoclonal antibody, or a combined liver-kidney transplantation. CASE-DIAGNOSIS/TREATMENT: A child with a homozygous CFH deficiency underwent a successful liver-kidney transplantation...
October 15, 2016: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
Mathijs van de Vrie, Jeroen K Deegens, Michael Eikmans, Johan van der Vlag, Luuk B Hilbrands
Urine represents a non-invasive source in which proteins and nucleic acids can be assessed. Such analytes may function as biomarkers to monitor kidney graft pathology at every desired frequency, thereby providing a time window to prevent graft damage by therapeutic intervention. Recently, several proteins have been measured in urine as markers of graft injury. However, the specificity is limited, and measuring urinary proteins generally lacks the potential to predict early kidney graft damage. Currently, urinary mRNA and microRNA are being investigated to evaluate the prognostic value of changes in gene expression during the initial stages of graft damage...
October 15, 2016: American Journal of Transplantation
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