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https://www.readbyqxmd.com/read/27913812/association-between-cytokines-and-their-receptor-antagonist-gene-polymorphisms-and-clinical-risk-factors-and-acute-rejection-following-renal-transplantation
#1
SIqing Ding, Jianfei Xie, Qiquan Wan
BACKGROUND Acute rejection (AR) after renal transplantation affects both patient and graft survival. There is growing evidence of the genetic association between cytokine or its receptor antagonist and AR in solid organ transplantation. The objectives of this study were to investigate the role of recipient TNF β, IL-10, IL-1β, and IL-1 receptor antagonist (ra) gene polymorphism, as well as traditional clinical variables such as panel-reactive antibody (PRA) levels, donor type, and HLA mismatches in AR following renal transplantation...
December 3, 2016: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
https://www.readbyqxmd.com/read/27895419/acute-kidney-injury-and-post-reperfusion-syndrome-in-liver-transplantation
#2
REVIEW
Ilaria Umbro, Francesca Tinti, Irene Scalera, Felicity Evison, Bridget Gunson, Adnan Sharif, James Ferguson, Paolo Muiesan, Anna Paola Mitterhofer
In the past decades liver transplantation (LT) has become the treatment of choice for patients with end stage liver disease (ESLD). The chronic shortage of cadaveric organs for transplantation led to the utilization of a greater number of marginal donors such as older donors or donors after circulatory death (DCD). The improved survival of transplanted patients has increased the frequency of long-term complications, in particular chronic kidney disease (CKD). Acute kidney injury (AKI) post-LT has been recently recognized as an important risk factor for the occurrence of de novo CKD in the long-term outcome...
November 14, 2016: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/27779800/the-expanded-criteria-donor-for-kidney-transplant-not-a-nearly-new-car
#3
Johan De Meester
From late nineteen nineties, the higher number of suitable renal transplant candidates has forced the transplant community to re-explore the whole spectrum of deceased donors after brain death (DBD) as well as after cardiac death (DCD); in practice, donors of older age and donors with more chronic diseases or "medical complexities". This new kidney donor population - finally defined as extended criteria donors (ECD) - currently comprises on average 20 to 25%. In his seminal paper in 2003 on the introduction of ECD in the US, Metzger et al...
October 25, 2016: Transplant International: Official Journal of the European Society for Organ Transplantation
https://www.readbyqxmd.com/read/27779281/policy-options-for-increasing-the-supply-of-transplantable-kidneys-in-singapore
#4
Jia Loon Chong
Kidney transplantation is the preferred treatment for eligible end-stage renal disease patients. However, the supply of donated kidneys has been consistently insufficient to meet the transplantation requirements of the population. In this paper, I discuss the feasibility of several policy options that engage potential donors or key individuals in a Singapore context, including financial and non-financial incentives for deceased/living organ donors and their families, improving actualisation rates of both donation after brain death, donation after cardiac death through quality improvement programmes and remuneration schemes, and a media platform for directed organ donation...
October 2016: Singapore Medical Journal
https://www.readbyqxmd.com/read/27749583/maximizing-kidneys-for-transplantation-using-machine-perfusion-from-the-past-to-the-future-a-comprehensive-systematic-review-and-meta-analysis
#5
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)
https://www.readbyqxmd.com/read/27729570/stretching-the-limits-of-renal-transplantation-in-elderly-recipients-of-grafts-from-elderly-deceased-donors
#6
Hessel Peters-Sengers, Stefan P Berger, Martin B A Heemskerk, Doaa Al Arashi, Jaap J Homan van der Heide, Aline C Hemke, Ineke J M Ten Berge, Mirza M Idu, Michiel G H Betjes, Arjan D van Zuilen, Luuk B Hilbrands, Aiko P J de Vries, Azam S Nurmohamed, Maarten H Christiaans, L W Ernest van Heurn, Johan W de Fijter, Frederike J Bemelman
An increasing number of elderly patients (≥65 years) receive a donor kidney from elderly donors after brain death (DBD) or after circulatory death (DCD). These organs are allocated within the Eurotransplant Senior Program, but outcomes must be evaluated. From the Dutch Organ Transplantation Registry, we selected 3597 recipients (≥18 years) who received a first DBD or DCD kidney during 2002-2012, and categorized them as young or elderly recipients receiving a graft from either a young or elderly donor, stratified by donor type...
October 11, 2016: Journal of the American Society of Nephrology: JASN
https://www.readbyqxmd.com/read/27647696/continuous-normothermic-ex-vivo-kidney-perfusion-is-superior-to-brief-normothermic-perfusion-following-static-cold-storage-in-donation-after-circulatory-death-pig-kidney-transplantation
#7
J M Kaths, J Y Cen, Y M Chun, J Echeverri, I Linares, S Ganesh, P Yip, R John, D Bagli, I Mucsi, A Ghanekar, D R Grant, L A Robinson, M Selzner
Hypothermic preservation is known to cause renal graft injury, especially in donation after circulatory death (DCD) kidney transplantation. We investigated the impact of cold storage (SCS) versus short periods of normothermic ex vivo kidney perfusion (NEVKP) after SCS versus prolonged, continuous NEVKP with near avoidance of SCS on kidney function after transplantation. Following 30 min of warm ischemia, kidneys were removed from 30-kg Yorkshire pigs and preserved for 16 h with (A) 16 h SCS, (B) 15 h SCS + 1 h NEVKP, (C) 8 h SCS + 8 h NEVKP, and (D) 16 h NEVKP...
September 20, 2016: American Journal of Transplantation
https://www.readbyqxmd.com/read/27565133/the-changing-financial-landscape-of-renal-transplant-practice-a-national-cohort-analysis
#8
D A Axelrod, M A Schnitzler, H Xiao, A S Naik, D L Segev, V R Dharnidharka, D C Brennan, K L Lentine
Kidney transplantation has become more resource intensive as recipient complexity has increased and average donor quality has diminished over time. A national retrospective cohort study was performed to assess the impact of kidney donor and recipient characteristics on transplant center cost (exclusive of organ acquisition) and Medicare reimbursement. Data from the national transplant registry, University HealthSystem Consortium hospital costs, and Medicare payments for deceased donor (N = 53 862) and living donor (N = 36 715) transplants from 2002 to 2013 were linked and analyzed using multivariate linear regression modeling...
August 27, 2016: American Journal of Transplantation
https://www.readbyqxmd.com/read/27513209/inhibition-of-coagulation-proteases-xa-and-iia-decreases-ischemia-reperfusion-injuries-in-a-preclinical-renal-transplantation-model
#9
Solenne Tillet, Sébastien Giraud, Thomas Kerforne, Thibaut Saint-Yves, Sandrine Joffrion, Jean-Michel Goujon, Jerôme Cau, Gérard Mauco, Maurice Petitou, Thierry Hauet
Coagulation is an important pathway in the pathophysiology of ischemia-reperfusion injuries. In particular, deceased after circulatory death (DCD) donors undergo a no-flow period, a strong activator of coagulation. Hence, therapies influencing the coagulation cascade must be developed. We evaluated the effect of a new highly specific and effective anti-Xa/IIa molecule, with an integrated innovative antidote site (EP217609), in a porcine preclinical model mimicking injuries observed in DCD donor kidney transplantation...
July 25, 2016: Translational Research: the Journal of Laboratory and Clinical Medicine
https://www.readbyqxmd.com/read/27479168/the-impact-of-total-ischaemic-time-donor-age-and-the-pathway-of-donor-death-on-graft-outcomes-after-deceased-donor-kidney-transplantation
#10
G Wong, A Teixeira-Pinto, J R Chapman, J C Craig, Henry Pleass, S McDonald, W H Lim
BACKGROUND: Prolonged ischaemia is a known risk factor for delayed graft function and its interaction with donor characteristics, the pathways of donor death and graft outcomes may have important implications for allocation policies. METHODS: Using data from the ANZDATA registry (1994-2013), we examined the relationship between total ischaemic time with graft outcomes among recipients who received their first deceased donor kidney transplants. Total ischaemic time (in hours) was defined as the time of the donor renal artery interruption or aortic clamp, until the time of release of the clamp on the renal artery in the recipient...
July 29, 2016: Transplantation
https://www.readbyqxmd.com/read/27467537/continuous-normothermic-ex-vivo-kidney-perfusion-improves-graft-function-in-donation-after-circulatory-death-pig-kidney-transplantation
#11
J Moritz Kaths, Juan Echeverri, Yi Min Chun, Jun Yu Cen, Nicolas Goldaracena, Ivan Linares, Luke S Dingwell, Paul Yip, Rohan John, Darius Bagli, Istvan Mucsi, Anand Ghanekar, David Grant, Lisa Robinson, Markus Selzner
BACKGROUND: Donation after circulatory death (DCD) is current clinical practice to increase the donor pool. Deleterious effects on renal graft function are described for hypothermic preservation. Therefore, current research focuses on investigating alternative preservation techniques such as normothermic perfusion. METHODS: We compared continuous pressure-controlled normothermic ex vivo kidney perfusion (NEVKP) with static cold storage (SCS) in a porcine model of DCD autotransplantation...
July 27, 2016: Transplantation
https://www.readbyqxmd.com/read/27421771/negative-impact-of-prolonged-cold-storage-time-before-machine-perfusion-preservation-in-donation-after-circulatory-death-kidney-transplantation
#12
Siegfredo Paloyo, Junichiro Sageshima, Jeffrey J Gaynor, Linda Chen, Gaetano Ciancio, George W Burke
Kidney grafts are often preserved initially in static cold storage (CS) and subsequently on hypothermic machine perfusion (MP). However, the impact of CS/MP time on transplant outcome remains unclear. We evaluated the effect of prolonged CS/MP time in a single-center retrospective cohort of 59 donation after circulatory death (DCD) and 177 matched donation after brain death (DBD) kidney-alone transplant recipients. With mean overall CS/MP times of 6.0 h/30.0 h, overall incidence of delayed graft function (DGF) was higher in DCD transplants (30...
October 2016: Transplant International: Official Journal of the European Society for Organ Transplantation
https://www.readbyqxmd.com/read/27362304/uk-national-registry-study-of-kidney-donation-after-circulatory-death-for-pediatric-recipients
#13
Matko Marlais, Laura Pankhurst, Alex Hudson, Khalid Sharif, Stephen D Marks
BACKGROUND: Donation after circulatory death (DCD) kidney transplantation has acceptable renal allograft survival in adults but there are few data in pediatric recipients. The aim of this study was to determine renal allograft outcomes for pediatric recipients of a DCD kidney. METHODS: Data were collected from the UK Transplant Registry held by National Health Service Blood and Transplant. Kidney transplants performed for pediatric recipients (age, <18 years) in the United Kingdom from 2000 to 2014 were separated into DCD, donation after brain death (DBD), and living donor (LD) transplants, analyzing 3-year patient and renal allograft survival...
June 29, 2016: Transplantation
https://www.readbyqxmd.com/read/27273794/successful-transplantation-of-human-kidneys-deemed-untransplantable-but-resuscitated-by-ex-vivo-normothermic-machine-perfusion
#14
S A Hosgood, K Saeb-Parsy, M O Hamed, M L Nicholson
We report the successful transplantation of a pair of human kidneys that were declined for transplantation due to inadequate in situ perfusion but subsequently transplanted after perfusion and assessment using ex vivo normothermic perfusion (EVNP). The kidneys were from a 35-year-old man, a donation after circulatory death donor. Both kidneys were declined by all UK transplant centers. On arrival, the kidneys had significant areas of incomplete clearance of blood from the microcirculation that did not clear after a further attempt to flush them...
November 2016: American Journal of Transplantation
https://www.readbyqxmd.com/read/27266684/-massive-hemorrhage-caused-by-fungal-infections-after-donation-after-cardiac-death-kidney-transplantation-clinical-features-prevention-and-treatment-experience
#15
D D Zhao, Z Y Huang, L Q Hong, T Liao, Y E Tang, N Na, H Li, B Miao, X F Hua, Q Q Sun
OBJECTIVE: To study the characteristics and prevention and treatment strategies of massive hemorrhage caused by fungal infections after donation-after-cardiac-death (DCD) kidney transplantation. METHODS: A total of 91 cases of DCD kidney transplantation between August 25, 2013 and June 30, 2015 in Third Affiliated Hospital of Sun Yat-sen Univservity were retrospectively analyzed. The characteristics of and prevention and treatments strategies for postoperative massive hemorrhage caused by fungal infections were summarized...
May 31, 2016: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/27220256/a-novel-redox-active-metalloporphyrin-reduces-reactive-oxygen-species-and-inflammatory-markers-but-does-not-improve-marginal-mass-engraftment-in-a-murine-donation-after-circulatory-death-islet-transplantation-model
#16
Antonio Bruni, Andrew R Pepper, Boris Gala-Lopez, Rena Pawlick, Nasser Abualhassan, James D Crapo, Jon D Piganelli, A M James Shapiro
Islet transplantation is a highly effective treatment for stabilizing glycemic control for select patients with type-1 diabetes. Despite improvements to clinical transplantation, single-donor transplant success has been hard to achieve routinely, necessitating increasing demands on viable organ availability. Donation after circulatory death (DCD) may be an alternative option to increase organ availability however, these organs tend to be more compromised. The use of metalloporphyrin anti-inflammatory and antioxidant (MnP) compounds previously demonstrated improved in vivo islet function in preclinical islet transplantation...
July 3, 2016: Islets
https://www.readbyqxmd.com/read/27197998/dcd-liver-transplant-infection-experience-from-a-single-centre-in-china
#17
Z Tu, P Xiang, X Xu, L Zhou, L Zhuang, J Wu, W Wang, S Zheng
AIM: The purpose of our study was to evaluate the incidence, timing, location and risk factors for bacterial and fungal infections after donation after cardiac death (DCD) liver transplant and clearly delineate any relationship between infection and survival in DCD liver transplant recipients. METHODS: We retrospectively reviewed 257 consecutive patients undergoing DCD liver transplant between October 2010 and May 2015 at our centre. RESULTS: A total of 133 patients (51...
June 2016: International Journal of Clinical Practice
https://www.readbyqxmd.com/read/27182155/liver-transplantation-current-status-and-challenges
#18
REVIEW
Caroline C Jadlowiec, Timucin Taner
Great progress has been made in the field of liver transplantation over the past two decades. This progress, however, also brings up the next set of challenges: First, organ shortage remains a major limitation, and accounts for a large proportion of wait list mortality. While living donation has successfully increased the total number of liver transplants done in Asian countries, the total number of such transplants has been stagnant in the western hemisphere. As such, there has been a significant effort over the past decade to increase the existing deceased donor pool...
May 14, 2016: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/27163541/predictors-of-deceased-donor-kidney-discard-in-the-united-states
#19
Wesley J Marrero, Abhijit S Naik, John J Friedewald, Yongcai Xu, David W Hutton, Mariel S Lavieri, Neehar D Parikh
BACKGROUND: Renal transplantation is a lifesaving intervention for end-stage renal disease. The demand for renal transplantation outweighs the availability of organs; however, up to 20% of recovered kidneys are discarded before transplantation. We aimed to better characterize the risk factors for deceased donor kidney discard. METHODS: We performed a secondary analysis of the Organ Procurement and Transplantation Network database from 2000 to 2012 of all solid organ donors...
May 10, 2016: Transplantation
https://www.readbyqxmd.com/read/27097986/mechanisms-of-hypothermic-machine-perfusion-to-decrease-donation-after-cardiac-death-graft-inflammation-through-the-pathway-of-upregulating-expression-of-klf2-and-inhibiting-tgf-%C3%AE-signaling
#20
Zhongzhong Liu, Zibiao Zhong, Jianan Lan, Mingxia Li, Wei Wang, Jing Yang, Chenwei Tang, Jie Wang, Shaojun Ye, Yan Xiong, Yanfeng Wang, Qifa Ye
Hypothermic machine perfusion (HMP) has been known as an efficient way to improve kidney graft function, but the underlying mechanisms remain unclear. Here, we adopt a rabbit reperfusion mode to investigate the upstream mechanisms of end-ischemic HMP of kidneys from donors after cardiac death (DCD), with static cold storage (CS) as a control. Eighteen New Zealand healthy male rabbits (12 weeks old, with a weight of 3.0 ± 0.2 kg) were randomly divided into three groups: HMP group, CS group, and Normal group (n = 6)...
April 21, 2016: Artificial Organs
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