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https://www.readbyqxmd.com/read/29707626/single-graft-utilization-from-donors-with-severe-acute-kidney-injury-after-circulatory-death
#1
Yusuke Tomita, Kazuhiro Iwadoh, Yuichi Ogawa, Katsuyuki Miki, Kotaro Kai, Akihito Sannomiya, Toru Murakami, Ichiro Koyama, Kumiko Kitajima, Ichiro Nakajima, Shohei Fuchinoue
Chronic shortages of organs for transplantation have led to the use of marginal kidneys from donors after circulatory death with acute kidney injury (AKI), but the utilization of kidneys with severe AKI is not well established. We retrospectively analyzed eight kidney transplantation (KTx) cases from donation after circulatory death (DCD) with terminal creatinine (t-Cr) concentrations higher than 10.0 mg/dL and/or oliguria for more than 5 days (AKI network criteria: stage III). Although all patients showed delayed graft function, no cases of primary nonfunction (PNF) were found...
April 2018: Transplantation Direct
https://www.readbyqxmd.com/read/29677080/corm-401-reduces-ischemia-reperfusion-injury-in-an-ex-vivo-renal-porcine-model-of-the-donation-after-cardiac-death
#2
Rabindra N Bhattacharjee, Mahms Richard-Mohamed, Qizhi Sun, Aaron Haig, Ghaleb Aboalsamh, Peter Barrett, Richard Mayer, Ibrahim Alhasan, Karen Pineda-Solis, Larry Jiang, Hajed Alharbi, Manujendra Saha, Eric Patterson, Alp Sener, Gediminas Cepinskas, Anthony M Jevnikar, Patrick P W Luke
BACKGROUND: Carbon monoxide (CO) inhalation protects organ by reducing inflammation and cell death during transplantation processes in animal model. However, using CO in clinical transplantation is difficult due to its delivery in a controlled manner. A manganese-containing CORM-401 has recently been synthesized which can efficiently deliver 3 molar equivalents of CO. We report the ability of this anti-inflammatory CORM-401 to reduce ischemia reperfusion injury associated with prolonged cold storage of renal allografts obtained from donation after cardiac death in a porcine model of transplantation...
April 19, 2018: Transplantation
https://www.readbyqxmd.com/read/29602202/renal-resistance-trend-during-hypothermic-machine-perfusion-is-more-predictive-of-postoperative-outcome-than-biopsy-score-preliminary-experience-in-35-consecutive-kidney-transplantations
#3
Massimiliano Bissolati, Paolo Giovanni Gazzetta, Rossana Caldara, Giovanni Guarneri, Olga Adamenko, Fabio Giannone, Michele Mazza, Giulia Maggi, Deborah Tomanin, Riccardo Rosati, Antonio Secchi, Carlo Socci
Hypothermic machine perfusion (HPM) grants a better postoperative outcome in transplantation of organs procured from extended criteria donors (ECDs) and donors after cardiac death (DCD). So far, the only available parameter for outcome prediction concerning those organs is pretransplant biopsy score. The aim of this study is to evaluate whether renal resistance (RR) trend during HPM may be used as a predictive marker for post-transplantation outcome. From December 2015 to present, HMP has been systematically applied to all organs from ECDs and DCD...
March 30, 2018: Artificial Organs
https://www.readbyqxmd.com/read/29579845/results-of-controlled-donation-after-circulatory-death-in-a-third-level-hospital
#4
N Palomo-López, L Martín-Villén, Á J Roldán-Reina, Z Ruiz de Azúa-López, D X Cuenca-Apolo, M Adriaensens-Pérez, Y Corcia-Palomo, J J Egea-Guerrero
OBJECTIVE: To investigate the characteristics and evolution of controlled donation after circulatory death (DCD) type III. MATERIALS AND METHODS: Observational and retrospective study of controlled DCD type III of donors conducted from 2014 to 2016. Clinical data, intensive care unit (ICU) stay, cause of death, warm ischemia time, and total time were collected. Delayed graft function (DGF) and survival of renal transplant were also registered. Qualitative variables are described as frequencies and absolute values and quantitative variables as medians and interquartile ranges...
March 2018: Transplantation Proceedings
https://www.readbyqxmd.com/read/29579844/postoperative-care-in-kidney-transplantation-a-comparison-between-controlled-and-uncontrolled-donation-after-circulatory-death
#5
Á J Roldán-Reina, J J Egea-Guerrero, N Palomo-López, D X Cuenca-Apolo, M Adriaensens-Pérez, M Porras-López, Z Ruiz de Azúa-López, Y Corcia-Palomo, L Martín-Villén
Recent research in kidney transplantation has revealed differences in the evolution of renal function among patients transplanted from 2 alternative programs for donation after circulatory death (DCD). A retrospective, observational, single-center study was carried out from 2013 to 2016 at a level III hospital intensive care unit (ICU) to assess the progression of kidney recipients after transplants from uncontrolled DCD (uDCD) or controlled DCD (cDCD). The following variables were collected for data analysis: demographics, comorbidities, type of donation, lactate, hemoglobin and glucose levels at ICU admission, creatinine concentration at ICU admission, at-hospital ward transfer, at-hospital discharge, radioisotope imaging results, ICU and in-hospital length of stay, and mortality...
March 2018: Transplantation Proceedings
https://www.readbyqxmd.com/read/29570164/the-benefits-of-hypothermic-machine-preservation-and-short-cold-ischemia-times-in-deceased-donor-kidneys
#6
Jjhfm Kox, C Moers, D Monbaliu, A Strelniece, J Treckmann, I Jochmans, Hgd Leuvenink, Lwe Van Heurn, J Pirenne, A Paul, R J Ploeg
BACKGROUND: Hypothermic machine perfusion (HMP) of deceased donor kidneys is associated with better outcome when compared to static cold storage (CS). Nevertheless, there is little evidence whether kidneys with short cold ischemia time (CIT) also benefit from HMP and whether HMP can safely extend CIT. METHODS: We analysed prospectively collected data from the Machine Preservation Trial, an international randomized controlled trial. 752 Consecutive renal transplants were included: 1 kidney of each of the 376 donors was preserved by HMP, the contralateral organ was preserved by CS...
March 22, 2018: Transplantation
https://www.readbyqxmd.com/read/29407336/perfusion-parameters-of-donation-after-cardiac-death-kidneys-predict-early-transplant-outcomes-based-on-expanded-criteria-donor-designation
#7
Q Tai, W Xue, X Ding, P Tian, H Xiang, X Feng, H Yan, J Hou
BACKGROUND: Donation after cardiac death is the only source of the deceased donor in China at present. Hypothermic machine perfusion has been used increasingly over the years. We determined the hypothermic machine perfusion parameters associated with early transplant outcomes based on the expanded criteria donor (ECD) designation. METHODS: There were 446 consecutive kidneys donated after cardiac death and preserved by hypothermic machine perfusion (LifePort) in our center that were included in this study...
January 2018: Transplantation Proceedings
https://www.readbyqxmd.com/read/29407310/liver-transplant-recipients-with-end-stage-renal-disease-largely-benefit-from-kidney-transplantation
#8
T Yunhua, Z Qiang, J Lipeng, H Shanzhou, Z Zebin, J Fei, Z Zhiheng, W Linhe, J Weiqiang, W Dongping, G Zhiyong, H Xiaoshun
BACKGROUND: The incidence of end-stage renal disease (ESRD) after liver transplant (LT) has increased. The actual benefit of kidney transplantation (KT) is not completely understood in LT recipients with ESRD. METHODS: We analyzed Scientific Registry of Transplant Recipients data for all KT candidates with prior LT from 1998 to 2014; the benefits of KT relative to remaining on dialysis were compared by means of multivariate Cox proportional hazards regression analysis...
January 2018: Transplantation Proceedings
https://www.readbyqxmd.com/read/29374912/-selective-preimplantation-pathological-evaluation-in-renal-transplantation-a-single-center-s-experience
#9
F H Peng, J J Chen, L K Peng, X B Xie, G B Lan, S J Yu, Y Wang, X T Tang, H L Dai, C Gao, C H Fang
Objective: To summarize the clinical data of pre-implantation biopsy donors in our hospital and explore the clinical characteristics of those donors in pathological high-risk, and to provide references for the selective histological evaluation of extended criteria donor kidneys. Methods: We retrospectively reviewed the clinical data and pre-implantation renal pathologic score of donors from January 1, 2015 to May 1, 2017.During this period, 247 cases of donation after citizen's death (DCD) occurred.After clinical evaluation and selective machine perfusion( Lifeport) evaluation, 30 cases of pre-implantation pathological evaluation were performed...
January 16, 2018: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/29343027/-using-creatinine-reduction-ratio-as-a-predictor-for-delayed-graft-function-of-kindey-transplant-recipients-from-donor-of-cardiac-death
#10
Z J Sun, X D Zhang, L Ren, X Y Yang, J F Cai, X Li, X Zheng, W Wang
Objective: To explore the relationship between creatinine reduction ratio (CRR) and delayed graft function among kidney transplant recipients from donor of cardiac death (DCD). To define the value of CRR to predict delayed graft function (DGF) in early post-transplant period. Method: 86 patients were included, who received renal transplantation from DCD during Jan 1(st) 2011 to Jun 30(th) 2016. We performed a retrospective study and collected creatinine data within 3 days post-operation and marked them with Cr1, Cr2 , Cr3, and then calculated creatinine reduction ratio day-2 (CRR 2) =(Cr1-Cr2)/Cr1×100% and creatinine reduction ratio day-3 (CRR 3)=[(Cr1-Cr2)/Cr1+ (Cr2-Cr3)/Cr2]/2×100%...
January 2, 2018: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/29314286/the-impact-of-kidney-donor-profile-index-on-delayed-graft-function-and-transplant-outcomes-a-single-center-analysis
#11
Tiffany J Zens, Juan S Danobeitia, Glen Leverson, Peter J Chlebeck, Laura J Zitur, Robert R Redfield, Anthony M D'Alessandro, Scott Odorico, Dixon B Kaufman, Luis A Fernandez
INTRODUCTION: Renal transplant outcomes result from a combination of factors. Traditionally, donor factors were summarized by classifying kidneys as extended criteria or standard criteria. In 2014, the nomenclature changed to describe donor factors with the kidney donor profile index (KDPI). We aim to evaluate the relationship between KDPI and delayed graft function (DGF), and the impact KDPI on transplant outcomes for both donor after cardiac death (DCD) and donor after brain death (DBD)...
March 2018: Clinical Transplantation
https://www.readbyqxmd.com/read/29274240/do-clinical-trials-reflect-reality-a-systematic-review-of-inclusion-exclusion-criteria-in-trials-of-renal-transplant-immunosuppression
#12
Anam A Ayaz-Shah, Samia Hussain, Simon R Knight
Renal transplant recipients and donors are becoming increasingly more marginal, with more expanded criteria (ECD) and donation after circulatory death (DCD) donors and older recipients. Despite this, high-risk donors and recipients are often excluded from clinical trials, leading to uncertainty about the generalizability of findings. We extracted data regarding inclusion/exclusion criteria from 174 trials of immunosuppression in renal transplant recipients published over a 5-year period and compared criteria with those specified in published trial registries...
April 2018: Transplant International: Official Journal of the European Society for Organ Transplantation
https://www.readbyqxmd.com/read/29248914/whole-genome-analysis-of-an-extensive-drug-resistant-acinetobacter-baumannii-st195-isolate-from-a-recipient-after-dcd-renal-transplantation-in-china
#13
Hong Jiang, Luxi Cao, Qixia Shen, Lihui Qu, Yan Jiang, Tingting Qu, Jian Zhang, Yingying Lu, Bingjue Li, Chaohong Zhu, Guangjun Liu, Rending Wang, Miao Chen, Yucheng Wang, Yanfei Wang, Shi Feng, Junwen Wang, Yunsong Yu, Jianyong Wu, Jianghua Chen
BACKGROUND/AIMS: Infection with Acinetobacter baumannii was emerging as one of the leading causes of mortality after donation after cardiac death transpalantion. METHODS: We reported a case of a recipient who underwent DCD renal transplantation and later got infected by A.baumannii. Etests were done to verify the susceptibility test results in clinic. Whole-genome analysis was applied to investigate the resistant mechanism at gene level. RESULTS: The pathogen was isolated from his draining liquid the day after the surgery, and susceptibility test reavealed that it was sensitive to tigecycline...
2017: Kidney & Blood Pressure Research
https://www.readbyqxmd.com/read/29210064/normothermic-machine-perfusion-for-the-assessment-and-transplantation-of-declined-human-kidneys-from-donation-after-circulatory-death-donors
#14
S A Hosgood, E Thompson, T Moore, C H Wilson, M L Nicholson
BACKGROUND: A significant proportion of donation after circulatory death (DCD) kidneys are declined for transplantation because of concerns over their quality. Ex vivo normothermic machine perfusion (NMP) provides a unique opportunity to assess the quality of a kidney and determine its suitability for transplantation. METHODS: In phase 1 of this study, declined human DCD kidneys underwent NMP assessment for 60 min. Kidneys were graded 1-5 using a quality assessment score (QAS) based on macroscopic perfusion, renal blood flow and urine output during NMP...
March 2018: British Journal of Surgery
https://www.readbyqxmd.com/read/29123936/reconstruction-of-a-damaged-lower-polar-artery-for-kidney-transplantation-using-tubularised-donor-aorta
#15
A J Vicéns-Morton, C Callaghan, J Olsburgh
Introduction: Live donors, extended donor criteria, and the maximum usage of organs with anatomical variants are some of the mechanisms used to increase the number of organs available. Case: We present the case of a kidney transplant, in which the organ had an iatrogenic injury to a lower pole arterial branch during retrieval. The donor was a 35-year-old male (DCD, Maastricht III). The right kidney was accepted; it had three veins in a single cava patch and three renal arteries, the main artery with aorta patch that is 8 cm long...
2017: Case Reports in Transplantation
https://www.readbyqxmd.com/read/28975767/cd47-blockade-reduces-ischemia-reperfusion-injury-in-donation-after-cardiac-death-rat-kidney-transplantation
#16
Xuanchuan Wang, Min Xu, Jianluo Jia, Zhengyan Zhang, Joseph P Gaut, Gundumi A Upadhya, Pamela T Manning, Yiing Lin, William C Chapman
Modulation of nitric oxide activity through blockade of CD47 signaling has been shown to reduce ischemia-reperfusion injury (IRI) in various models of tissue ischemia. Here, we evaluate the potential effect of an antibody-mediated CD47 blockade in a syngeneic and an allogeneic DCD rat kidney transplant model. The donor organ was subjected to 1 hour of warm ischemia time after circulatory cessation, then flushed with a CD47 monoclonal antibody (CD47mAb) in the treatment group, or an isotype-matched immunoglobulin in the control group...
April 2018: American Journal of Transplantation
https://www.readbyqxmd.com/read/28889600/normothermic-ex-vivo-kidney-perfusion-for-graft-quality-assessment-prior-to-transplantation
#17
J Moritz Kaths, Mátyás Hamar, Juan Echeverri, Ivan Linares, Peter Urbanellis, Jun Yu Cen, Sujani Ganesh, Luke S Dingwell, Paul Yip, Rohan John, Darius Bagli, Istvan Mucsi, Anand Ghanekar, David Grant, Lisa A Robinson, Markus Selzner
Normothermic ex vivo kidney perfusion (NEVKP) represents a novel approach for graft preservation and functional improvement in kidney transplantation. We investigated whether NEVKP also allows graft quality assessment before transplantation. Kidneys from 30-kg pigs were recovered in a model of heart-beating donation (group A) after 30 minutes (group B) or 60 minutes (group C) (n = 5/group) of warm ischemia. After 8 hours of NEVKP, contralateral kidneys were resected, grafts were autotransplanted, and the pigs were followed for 3 days...
March 2018: American Journal of Transplantation
https://www.readbyqxmd.com/read/28771455/confirmed-transmission-of-bacterial-or-fungal-infection-to-kidney-transplant-recipients-from-donated-after-cardiac-death-dcd-donors-in-china-a-single-center-analysis
#18
Qiquan Wan, Huanmiao Liu, Shaojun Ye, Qifa Ye
BACKGROUND We aimed to investigate blood and urine cultures of donated after cardiac death (DCD) donors and report the cases of confirmed (proven/probable) transmission of bacterial or fungal infection from donors to kidney recipients. MATERIAL AND METHODS Seventy-eight DCD donors between 2010 and 2016 were included. Sixty-one DCD donors underwent blood cultures and 22 episodes of bacteremias developed in 18 donors. Forty-three donors underwent urine cultures and 14 donors experienced 17 episodes of urinary infections...
August 3, 2017: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
https://www.readbyqxmd.com/read/28742013/first-canadian-experience-with-donation-after-cardiac-death-simultaneous-pancreas-and-kidney-transplants
#19
Patrick T Anderson, Shahid Aquil, Kelly McLean, Vivian C McAlister, Alp Sener, Patrick P Luke
BACKGROUND: Compared with neurologic determination of death (NDD) donor organs, donation after cardiac death (DCD) donor organs have traditionally been considered of inferior quality owing to warm ischemia experienced during procurement. We present, to our knowledge, the first analysis of simultaneous pancreas and kidney (SPK) transplants using DCD donor organs in Canada. METHODS: We carried out a retrospective cohort study of SPK transplants from 13 DCD and 68 NDD donors performed between October 2008 and July 2016...
September 2017: Canadian Journal of Surgery. Journal Canadien de Chirurgie
https://www.readbyqxmd.com/read/28690174/clinical-outcomes-of-donation-after-circulatory-death-liver-transplantation-in-primary-sclerosing-cholangitis
#20
Palak J Trivedi, Irene Scalera, Emma Slaney, Richard W Laing, Bridget Gunson, Gideon M Hirschfield, Andrea Schlegel, James Ferguson, Paolo Muiesan
BACKGROUND & AIM: Primary sclerosing cholangitis (PSC) is a progressive fibro-inflammatory cholangiopathy for which liver transplantation is the only life-extending intervention. These patients may benefit from accepting liver donation after circulatory death (DCD), however their subsequent outcome is unknown. The aim of this study was to determine the clinical impact of using DCD liver grafts in patients specifically undergoing transplantation for PSC. METHODS: Clinical outcomes were prospectively evaluated in PSC patients undergoing transplantation from 2006 to 2016 stratified by donor type (DCD, n=35 vs...
November 2017: Journal of Hepatology
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