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Living donor kidney transplant

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https://www.readbyqxmd.com/read/28110269/genetic-predictors-of-long-term-graft-function-in-kidney-and-pancreas-transplant-patients
#1
Claire E Duff, Matthew J Simmonds
Kidney and pancreas transplantation have helped transform the lives of people with end-stage renal failure and individuals with type 1 diabetes who have poor glycaemic control/severe secondary complications, respectively. Despite an improvement in immunosuppressive regimes, operative techniques and decreased initial rejection rates, there has been little improvement in long-term graft survival rates over the past decade. Whilst limited progress has been made in establishing clinical markers of graft function, several genetic markers of long-term graft function have been identified...
January 20, 2017: Briefings in Functional Genomics
https://www.readbyqxmd.com/read/28104165/highly-immunogenic-dqb1-mismatch-eplets-are-associated-with-development-of-chronic-active-antibody-mediated-rejection-a-first-report-from-japan
#2
D Iwami, K Hotta, H Sasaki, T Hirose, H Higuchi, Y Takada, N Shinohara
BACKGROUND: De novo donor-specific antibody (dnDSA), especially against class II HLA, correlates with chronic active antibody-mediated rejection (CAAMR), which eventually leads to graft loss. It would be helpful if we could identify the patients at high risk of dnDSA development in terms of histocompatibility. Structure-based matching strategy assessing mismatched epitopes/eplets by comparing polymorphic amino acid sequences can predict the risk of development of dnDSA and CAAMR. However, it has not been evaluated in Japanese patients whose diversity in HLA is limited...
January 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28104162/hypoxia-inducible-factor-1%C3%AE-expression-in-kidney-transplant-biopsy-specimens-after-reperfusion-is-associated-with-early-recovery-of-graft-function-after-cadaveric-kidney-transplantation
#3
T Oda, T Ishimura, N Yokoyama, S Ogawa, H Miyake, M Fujisaw
BACKGROUND: Ischemia/reperfusion injury during kidney transplantation (KTx) delays allograft recovery. Hypoxia-inducible factor-1α (HIF-1α) is the key regulator of the protective response to ischemia/reperfusion injury. We evaluated the impact of the HIF-1α signaling pathway on allograft recovery during cadaveric KTx. METHODS: Between 1996 and 2015, 46 patients underwent cadaveric KTx. The expression levels of HIF-1α-related proteins, including phosphoinositide 3-kinase, phosphorylated (p)-Akt, p-mammalian target of rapamycin, p-Eukaryotic translation initiation factor 4E, p-S6 ribosomal protein, and HIF-1α, were immunohistochemically evaluated and semi-quantitatively scored in graft biopsy specimens after 1 hour of revascularization...
January 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28104152/experience-of-quatro-therapy-with-everolimus-to-minimize-calcineurin-inhibitor-for-kidney-transplant-recipients
#4
N Nakamura, T Miyazaki, H Matsuzaki, R Furuya, S Miyajima, S Irie, H Matsuoka, M Tanaka
BACKGROUND: This study was divided into three phases, on the occasion of the introduction of everolimus (EVR) in our hospital. METHODS: In the first phase, a study group of six maintenance patients (three living related donors, three deceased donors) who had a history of malignant disease with less than 500 mg/day of proteinuria were enrolled; a high serum creatinine and upper limit of duration after kidney transplant operation was not considered. EVR was discontinued in four of the six patients because of side effects or worsening renal function...
January 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28104150/comparison-of-mizoribine-and-mycophenolate-mofetil-with-a-tacrolimus-based-immunosuppressive-regimen-in-living-donor-kidney-transplantation-recipients-a-retrospective-study-in-china
#5
Y Shi, H Liu, X-G Chen, Z-Y Shen
BACKGROUND: A retrospective study was conducted to investigate the prevalence of gastrointestinal (GI) symptoms as well as the efficacy and safety of mizoribine (MZR) and mycophenolate mofetil (MMF) in Chinese living-donor kidney transplantation (LDKT). METHODS: Forty-two recipients enrolled between January 2012 and March 2014 were treated with either MZR (n = 22) or MMF (n = 20). All patients were treated in combination with a tacrolimus-based immunosuppressive regimen, besides the study drugs...
January 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28103829/a-comparison-of-the-effects-of-oral-vs-intravenous-hydration-on-subclinical-acute-kidney-injury-in-living-kidney-donors-a-protocol-of-a-randomised-controlled-trial
#6
Shona Mackinnon, Emma Aitken, Ryan Ghita, Marc Clancy
BACKGROUND: Optimal treatment for established renal failure is living donor kidney transplantation. However this pathway exposes healthy individuals to significant reduction in nephron mass via major surgical procedure. Laparoscopic donor nephrectomy is now the most common method for live donor transplantation, reducing both donor post-operative pain and recovery time. However this procedure exposes kidneys to additional haemodynamic stresses. It has been suggested that donor hydration-particularly the use of preoperative intravenous fluids-may counteract these stresses, reducing subclinical acute kidney injury and ultimately improving long-term renal function...
January 19, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/28102538/comparing-early-liver-graft-function-from-heart-beating-and-living-donors-a-pilot-study-aiming-to-identify-new-biomarkers-of-liver-injury
#7
Qi Joy Yang, Michael Kluger, Krzysztof Goryński, Janusz Pawliszyn, Barbara Bojko, Ai-Ming Yu, Keumhan Noh, Markus Selzner, Angela Jerath, Stuart McCluskey, K Sandy Pang, Marcin Wąsowicz
: Liver and kidney functions among recipients of liver transplantation (LT) surgery with heart beating (HBD, n = 13) or living donors (LD, n = 9) with different cold ischemic times were examined during the neohepatic phase for clearing rocuronium bromide (ROC, cleared by liver and kidney) and tranexamic acid (TXA, cleared by kidney). Solid phase micro-extraction and LC-MS/MS was applied to determine the plasma concentrations of ROC and TXA, and creatinine was determined by standard laboratory methods...
January 19, 2017: Biopharmaceutics & Drug Disposition
https://www.readbyqxmd.com/read/28095803/increased-glomerulonephritis-recurrence-after-living-related-donation
#8
A L Kennard, S H Jiang, G D Walters
BACKGROUND: Kidney transplantation confers superior outcomes for patients with end stage kidney disease, and live donor kidneys associate with superior outcomes compared to deceased donor kidneys. Modern immunosuppression has improved rejection rates and transplant survival and, as a result, recurrence of glomerulonephritis has emerged as a major cause of allograft loss. However, many glomerulonephritides have significant genetic risk which may manifest through kidney intrinsic or systemic mechanisms...
January 17, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/28092012/results-of-a-randomized-controlled-trial-analyzing-telemedically-supported-case-management-in-the-first-year-after-living-donor-kidney-transplantation-a-budget-impact-analysis-from-the-healthcare-perspective
#9
Klaus Kaier, Silvia Hils, Stefan Fetzer, Philip Hehn, Anja Schmid, Dieter Hauschke, Lioudmila Bogatyreva, Bernd Jänigen, Przemyslaw Pisarski
: ᅟ: We analyze one-year costs and savings of a telemedically supported case management program after kidney transplantation from the perspective of the German Healthcare System. Recipients of living donor kidney transplantation (N = 46) were randomly allocated to either (1) standard aftercare or (2) standard aftercare plus additional telemedically supported case management. A range of cost figures of each patient's medical service utilization were calculated at month 3, 6 and 12 and analyzed using two-part regression models...
December 2017: Health Economics Review
https://www.readbyqxmd.com/read/28088950/-risk-factors-for-acute-rejection-in-living-donor-kidney-transplant-recipients-in-china-a-subgroup-analysis-of-a-multi-center-registry-study
#10
X P Hu, Y Tian, T Y Zhu, J H Chen, C X Wang, X T Li, W J Xue, T Lin, L K Peng, J M Tan, G W Feng, Z S Chen, W K Han, J Dong, Y Fan, X D Zhang
Objective: To evaluate pre-and early post-transplantation risk factors for acute rejection(AR) in kidney recipients. Methods: This subgroup analysis of a multi-center registry study was conducted on living-donor kidney transplant recipients in China with 10 years of follow-up. This study analyzed 1 255 recipients including 921 males(73.4%) and with a mean age of (33±10)years. Data from patients were first analyzed with univariate analysis and then multivariate analysis was used for finding out the potential risk factors of AR...
January 10, 2017: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/28065559/post-listing-survival-for-highly-sensitised-patients-on-the-uk-kidney-transplant-waiting-list-a-matched-cohort-analysis
#11
Miriam Manook, Leonardo Koeser, Zubir Ahmed, Matthew Robb, Rachel Johnson, Olivia Shaw, Nicos Kessaris, Anthony Dorling, Nizam Mamode
BACKGROUND: More than 40% of patients awaiting a kidney transplant in the UK are sensitised with human leucocyte antigen (HLA) antibodies. Median time to transplantation for such patients is double that of unsensitised patients at about 74 months. Removing antibody to perform an HLA-incompatible (HLAi) living donor transplantation is perceived to be high risk, although patient survival data are limited. We compared survival of patients opting for an HLAi kidney transplant with that of similarly sensitised patients awaiting a compatible organ...
January 5, 2017: Lancet
https://www.readbyqxmd.com/read/28058214/older-candidates-for-kidney-transplantation-who-to-refer-and-what-to-expect
#12
REVIEW
Beatrice P Concepcion, Rachel C Forbes, Heidi M Schaefer
The number of older end-stage renal disease patients being referred for kidney transplantation continues to increase. This rise is occurring alongside the continually increasing prevalence of older end-stage renal disease patients. Although older kidney transplant recipients have decreased patient and graft survival compared to younger patients, transplantation in this patient population is pursued due to the survival advantage that it confers over remaining on the deceased donor waiting list. The upper limit of age and the extent of comorbidity and frailty at which transplantation ceases to be advantageous is not known...
December 24, 2016: World Journal of Transplantation
https://www.readbyqxmd.com/read/28058212/complement-related-kidney-diseases-recurrence-after-transplantation
#13
REVIEW
Maurizio Salvadori, Elisabetta Bertoni
The recurrence of renal disease after renal transplantation is becoming one of the main causes of graft loss after kidney transplantation. This principally concerns some of the original diseases as the atypical hemolytic uremic syndrome (HUS), the membranoproliferative glomerulonephritis (MPGN), in particular the MPGN now called C3 glomerulopathy. Both this groups of renal diseases are characterized by congenital (genetic) or acquired (auto-antibodies) modifications of the alternative pathway of complement...
December 24, 2016: World Journal of Transplantation
https://www.readbyqxmd.com/read/28058211/organ-transplantation-and-drug-eluting-stents-perioperative-challenges
#14
REVIEW
Aparna Dalal
Patients listed for organ transplant frequently have severe coronary artery disease (CAD), which may be treated with drug eluting stents (DES). Everolimus and zotarolimus eluting stents are commonly used. Newer generation biolimus and novolimus eluting biodegradable stents are becoming increasingly popular. Patients undergoing transplant surgery soon after the placement of DES are at increased risk of stent thrombosis (ST) in the perioperative period. Dual antiplatelet therapy (DAPT) with aspirin and a P2Y12 inhibitor such as clopidogrel, prasugrel and ticagrelor is instated post stenting to decrease the incident of ST...
December 24, 2016: World Journal of Transplantation
https://www.readbyqxmd.com/read/28052685/occurrence-of-malignancies-after-kidney-transplantation-in-adults-slovak-multicenter-experience
#15
Z Zilinska, M Sersenova, M Chrastina, J Breza Sr, L Bena, T Baltesova, A Jurcina, R Roland, E Lackova, M Cellar, L Laca, I Dedinska
Malignancies are one of the three major causes of renal recipient´s death with a functioning graft after cardiovascular diseases and infections. Among the variety of risk factors, including conventional and specific to transplant recipients, the duration of immunosuppressive therapy, the intensity of therapy, and the type of immunosuppressive agent all have an impact on development of post-transplant malignancy. The aim of our retrospective study was to document the incidence, the type of malignancies, the patient/graft survival in the group of kidney transplant recipients in Slovak Republic, and to identify the factors which influenced the outcome...
January 5, 2017: Neoplasma
https://www.readbyqxmd.com/read/28052609/optn-srtr-2015-annual-data-report-kidney
#16
A Hart, J M Smith, M A Skeans, S K Gustafson, D E Stewart, W S Cherikh, J L Wainright, A Kucheryavaya, M Woodbury, J J Snyder, B L Kasiske, A K Israni
The first full year of data after implementation of the new kidney allocation system reveals an increase in deceased donor kidney transplants among black candidates and those with calculated panel-reactive antibodies 98%-100%, but a decrease among candidates aged 65 years or older. Data from 2015 also demonstrate ongoing positive trends in graft and patient survival for both deceased and living donor kidney transplants, but the challenges of a limited supply of kidneys in the setting of increasing demand remain evident...
January 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/28052302/rationale-for-the-evaluation-of-renal-functional-reserve-in-living-kidney-donors-and-recipients-a-pilot-study
#17
Alessandra Spinelli, Aashish Sharma, Gianluca Villa, Sara Samoni, Francesco Ramponi, Alessandra Brocca, Alessandra Brendolan, Stefano Chiaramonte, Giuseppe Castellano, Loreto Gesualdo, Claudio Ronco
BACKGROUND: In living kidney transplantation, preoperative donors' renal functional reserve (RFR) may correlate with postoperative residual renal function in both donors and recipients. The aim of this study was to evaluate the donors' RFR before transplantation and to compare basal and stress renal function before and after transplantation in both donors and recipients. METHODS: Seven pairs of living kidney donors and recipients were considered for this observational study...
January 5, 2017: Nephron
https://www.readbyqxmd.com/read/28039956/longitudinal-analysis-of-living-donor-kidney-transplant-rates-in-pediatric-candidates-in-the-united-states
#18
Douglas S Keith, Gayle Vranic, John Barcia, Victoria Norwood, Angie Nishio-Lucar
Among adults, living donor kidney transplant rates began declining in the United States after 2004 but whether a similar decline is occurring in the pediatric candidates has not been well studied. Share 35, a change in allocation rules implemented in October of 2005, may also have influenced rates of living donation. We sought to determine whether a decline in rates was occurring in pediatric candidates and whether the Share 35 program was the cause of the decline. All children listed for a kidney transplant or transplanted with a living donor without listing between 1996 and 2011 were identified in the United States (N=14 911) of which 6046 had received a living donor transplant during follow-up...
December 30, 2016: Pediatric Transplantation
https://www.readbyqxmd.com/read/28036114/does-statins-promote-vascular-calcification-in-chronic-kidney-disease
#19
Zhimin Chen, Abdul Rashid Qureshi, Paolo Parini, Eva Hurt-Camejo, Jonaz Ripsweden, Torkel B Brismar, Peter Barany, Armand Jaminon, Leon J Schurgers, Olof Heimburger, Bengt Lindholm, Peter Stenvinkel
BACKGROUND: In end-stage renal disease (ESRD), coronary artery calcification (CAC) and inflammation contribute to cardiovascular disease (CVD). Statins do not improve survival in ESRD patients and their effect on vascular calcification is unclear. We explored associations between CAC, inflammatory biomarkers, statins and mortality in ESRD. MATERIAL AND METHODS: In 240 ESRD patients (63% males; median age 56 years) from cohorts including 86 recipients of living donor kidney transplant (LD-Rtx), 96 incident dialysis patients and 58 prevalent peritoneal dialysis patients, associations of CAC score (Agatston Units, AUs), interleukin-6 (IL-6) with high-sensitivity C-reactive protein (hsCRP), tumour necrosis factor (TNF), use of statins and all-cause mortality were analysed...
December 30, 2016: European Journal of Clinical Investigation
https://www.readbyqxmd.com/read/28031344/lifetime-risk-of-renal-replacement-therapy-in-europe-a-population-based-study-using-data-from-the-era-edta-registry
#20
Jan A J G van den Brand, Maria Pippias, Vianda S Stel, Fergus J Caskey, Frederic Collart, Partik Finne, James Heaf, Jean-Philippe Jais, Reinhard Kramar, Ziad A Massy, Johan De Meester, Jamie P Traynor, Anna Varberg Reisæter, Jack F M Wetzels, Kitty J Jager
BACKGROUND: Upcoming KDIGO guidelines for the evaluation of living kidney donors are expected to move towards a personal risk-based evaluation of potential donors. We present the age and sex-specific lifetime risk of renal replacement therapy (RRT) for end-stage renal disease in 10 European countries. METHODS: We defined lifetime risk of RRT as the cumulative incidence of RRT up to age 90 years. We obtained RRT incidence rates per million population by 5-year age groups and sex using data from the European Renal Association-European Dialysis and Transplant Association (ERA-EDTA) Registry, and used these to estimate the cumulative incidence of RRT, adjusting for competing mortality risk...
December 28, 2016: Nephrology, Dialysis, Transplantation
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