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Living donor kidney transplant

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https://www.readbyqxmd.com/read/28428030/complement-inhibition-with-eculizumab-for-thrombotic-microangiopathy-rescues-a-living-donor-kidney-transplant-in-a-patient-with-antiphospholipid-antibody-syndrome
#1
Praveen Ramakrishnan Geethakumari, Patrick Mille, Rakesh Gulati, Srikanth Nagalla
Antiphospholipid antibody syndrome (APS) is an enigmatic heterogeneous disorder despite several revelations in its pathobiology. Renal transplantation in patients with APS has been notoriously difficult due to the high risk of development of thrombotic microangiopathy (TMA), which is often refractory to conventional treatment modalities such as aggressive anticoagulation and plasmapheresis. We describe a case of a 58-year-old male with secondary APS undergoing living unrelated renal transplantation for end-stage renal disease from lupus nephritis...
March 10, 2017: Transfusion and Apheresis Science
https://www.readbyqxmd.com/read/28421681/early-clinical-xenotransplantation-experiences-an-interview-with-thomas-e-starzl-md-phd
#2
REVIEW
David K C Cooper
Dr Thomas E. Starzl, who died on March 4, 2017, was one of the great pioneers of organ transplantation. He was also a pioneer in the field of xenotransplantation. In 1964, he carried out baboon kidney transplants in six patients with terminal renal disease for whom no living or deceased donor became available; graft survival was for 19-60 days, the grafts being lost largely through continuous complement activation. Between 1966 and 1974, he carried out one ex vivo liver perfusion and three orthotopic liver transplants using chimpanzees as sources of organs; graft survival was for <14 days...
March 2017: Xenotransplantation
https://www.readbyqxmd.com/read/28419995/hemolytic-uremic-syndrome-and-kidney-transplantation-a-case-series-and-review-of-the-literature
#3
Sabrina Milan Manani, Grazia Maria Virzì, Anna Giuliani, Anna Clementi, Alessandra Brocca, Daniela Dissegna, Francesca Martino, Emanuele Stefano Giovanni d'Amore, Claudio Ronco
BACKGROUND: Hemolytic uremic syndrome (HUS) can be triggered by Shiga toxin producing Escherichia coli (STEC) infection or it can be defined as atypical HUS (aHUS) if it is related to uncontrolled complement activation. aHUS is characterized by a high incidence of recurrence after kidney transplantation, and it can also occur de novo in transplant recipients. Eculizumab is used both to prevent and to treat aHUS following kidney transplantation. In this paper, we report our centre experience and we present 4 cases of HUS in patients who underwent kidney transplantation...
April 19, 2017: Nephron
https://www.readbyqxmd.com/read/28411357/kidney-transplant-from-a-deceased-donor-with-renal-artery-aneurysm-a-case-report
#4
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/28406085/a-single-center-kidney-transplant-experience-among-ten-caucasian-females-with-end-stage-renal-disease-due-to-scleroderma%C3%A2
#5
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/28391343/cost-effectiveness-of-eculizumab-treatment-after-kidney-transplantation-in-patients-with-atypical-haemolytic-uraemic-syndrome
#6
Jan A J G van den Brand, Jacobien C Verhave, Eddy M Adang, Jack F M Wetzels
Background: Kidney transplantation in patients with atypical haemolytic uraemic syndrome (aHUS) is frequently complicated by recurrence of aHUS, often resulting in graft loss. Eculizumab prophylaxis prevents recurrence, improving graft survival. An alternative treatment strategy has been proposed where eculizumab is administered upon recurrence. We combined available evidence and performed a cost-effectiveness analysis of these competing strategies. Methods: A cost-effectiveness analysis using a decision analytical approach with Markov chain analyses was used to compare alternatives for aHUS patients with end-stage renal disease (ESRD): (i) dialysis treatment, (ii) kidney transplantation, (iii) kidney transplantation with eculizumab therapy upon recurrence of aHUS, (iv) kidney transplantation with eculizumab induction consisting of 12 months of prophylaxis and (v) kidney transplantation with lifelong eculizumab prophylaxis...
January 1, 2017: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/28390094/early-experience-with-hypothermic-machine-perfusion-of-living-donor-kidneys
#7
Michael Moser, Nathan Ginther, Yigang Luo, Gavin Beck, Ronn Ginther, Marla Ewen, Rhianna Matsche-Neufeld, Ahmed Shoker, Grzegorz Sawicki
BACKGROUND: Although hypothermic machine perfusion (HMP) has been shown to be beneficial to deceased donor kidneys, the effect of HMP on Living Donor Kidneys (LDK) is unknown. LDK are subjected to minutes of normothermic ischemia at the time of recovery. METHODS: Comparison of 16 LDK preserved by HMP with 16 LDK preserved by static cold storage (SCS). Outcomes of interest are resistive indices (RI), both while on HMP and postoperatively, and creatinine clearance (CrCl)...
April 8, 2017: Transplant International: Official Journal of the European Society for Organ Transplantation
https://www.readbyqxmd.com/read/28379431/barriers-to-living-donor-kidney-transplantation-in-the-united-kingdom-a-national-observational-study
#8
Diana A Wu, Matthew L Robb, Christopher J E Watson, John L R Forsythe, Charles R V Tomson, John Cairns, Paul Roderick, Rachel J Johnson, Rommel Ravanan, Damian Fogarty, Clare Bradley, Andrea Gibbons, Wendy Metcalfe, Heather Draper, Andrew J Bradley, Gabriel C Oniscu
Background.: Living donor kidney transplantation (LDKT) provides more timely access to transplantation and better clinical outcomes than deceased donor kidney transplantation (DDKT). This study investigated disparities in the utilization of LDKT in the UK. Methods.: A total of 2055 adults undergoing kidney transplantation between November 2011 and March 2013 were prospectively recruited from all 23 UK transplant centres as part of the Access to Transplantation and Transplant Outcome Measures (ATTOM) study...
March 31, 2017: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/28378695/-waiting-list-registration-for-kidney-transplants-must-improve
#9
B J J M Haase-Kromwijk, M B A Heemskerk, W Weimar, S P Berger, A J Hoitsma
OBJECTIVE: To investigate how the composition of the waiting list for postmortem kidney transplant has developed, and whether the waiting list reflects actual demand. DESIGN: Retrospective research and cohort study. METHOD: We used data from the period 2000-2014 from the Dutch Transplant Foundation, 'RENINE' and Eurotransplant. This concerned data on postmortem kidney donation, live donor transplants, the waiting list and kidney transplantation...
2017: Nederlands Tijdschrift Voor Geneeskunde
https://www.readbyqxmd.com/read/28377543/mycobacterium-tuberculosis-in-solid-organ-transplantation-incidence-before-and-after-expanded-isoniazid-prophylaxis
#10
Suad Mohamed Al-Mukhaini, Hassan Al-Eid, Fatima Alduraibi, Hanan Ibrahim Hakami, Haifa Al Talhi, Mohamed Shoukri, Ahmed M Ahmed, Yusuf Ahmed, Abdulrahman A Alrajhi
BACKGROUND: The risk of tuberculosis is increased in solid organ transplantation. Rates remain high in developed and developing countries. We developed protocols to better identify transplant recipients at risk of tuberculosis and initiate interventions to prevent tuberculosis. OBJECTIVES: Report tuberculosis incidence in solid-organ transplant recipients and the results of expanded isoniazid prophylaxis in deceased-donor renal transplantation. DESIGN: Retrospective cohort study, comparing two time periods...
March 2017: Annals of Saudi Medicine
https://www.readbyqxmd.com/read/28376034/rapid-discontinuation-of-prednisone-in-kidney-transplant-recipients-15-year-outcomes-from-the-university-of-minnesota
#11
Oscar Kenneth Serrano, Raja Kandaswamy, Kristen Gillingham, Srinath Chinnakotla, Ty B Dunn, Erik Finger, William Payne, Hassan Ibrahim, Aleksandra Kukla, Richard Spong, Naim Issa, Timothy L Pruett, Arthur Matas
BACKGROUND: Short- and intermediate-term results have been reported after rapid discontinuation of prednisone (RDP) in kidney transplant recipients. Yet there has been residual concern about late graft failure in the absence of maintenance prednisone. METHODS: From October 1, 1999, through June 1, 2015, we performed a total of 1553 adult 1st and 2nd kidney transplants-1021 with a living donor (LD), 532 with a deceased donor (DD)-under our RDP protocol. We analyzed the 15-year actuarial overall patient survival (PS), graft survival (GS), death-censored graft survival (DCGS), and acute rejection-free survival (ARFS) rates for RDP compared to historical controls on maintenance prednisone...
April 3, 2017: Transplantation
https://www.readbyqxmd.com/read/28374343/factors-relevant-to-medication-non-adherence-in-kidney-transplant-a-systematic-review
#12
Stephanie Belaiche, Bertrand Décaudin, Sébastien Dharancy, Christian Noel, Pascal Odou, Marc Hazzan
Background Medication non-adherence is a major issue after transplant that can lead to misdiagnosis, rejection, poor health affecting quality of life, graft loss or death. Several estimations of adherence and related factors have previously been described but conclusions leave doubt as to the most accurate assessment method. Aim of the review To identify the factors most relevant to medication non-adherence in kidney transplant in current clinical practice. Method This systematic review is registered in the PROSPERO data base and follows the Prisma checklist...
April 3, 2017: International Journal of Clinical Pharmacy
https://www.readbyqxmd.com/read/28372986/assessing-the-potential-of-angiotensin-ii-type-1-receptor-and-donor-specific-anti-endothelial-cell-antibodies-to-predict-long-term-kidney-graft-outcome
#13
David F Pinelli, John J Friedewald, Kelley M K Haarberg, Shree L Radhakrishnan, Jennifer R Zitzner, Wendy Wegner, Anat R Tambur
Endothelial cell antigens have been reported as potential targets for antibodies in the context of organ transplantation, leading to increased risk for graft failure. Serum samples from 142 consecutive living donor kidney recipients were tested for the presence of antibodies to Angiotensin II - Type 1 Receptor (AT1R), donor endothelial cells, and donor HLA. Graft survival was monitored for five years post-transplant, and secondary outcomes, including biopsy-proven rejection, proteinuria, biopsy-proven vasculopathy, and renal function based on serum creatinine were also assessed for the first two to three years...
March 31, 2017: Human Immunology
https://www.readbyqxmd.com/read/28366942/renal-and-cardiac-assessment-of-living-kidney-donor-candidates
#14
REVIEW
Ngan N Lam, Krista L Lentine, Amit X Garg
Living kidney donation provides the best therapeutic outcomes for eligible patients with end-stage renal disease. To ensure suitability for living kidney donation, donor candidates undergo a thorough medical, surgical, and psychosocial evaluation by a multidisciplinary transplant assessment team. Numerous guidelines are available to assist clinicians in the process of donor evaluation and selection. These guidelines outline the minimum recommended requirements for donor screening and additional tests that are indicated when abnormalities arise; however, evidence suggests that some of these additional tests might not be required in certain donor candidates...
April 3, 2017: Nature Reviews. Nephrology
https://www.readbyqxmd.com/read/28342273/characteristics-of-compatible-pair-participants-in-kidney-paired-donation-at-a-single-center
#15
Francis L Weng, Tracy Grogan, Anup M Patel, Shamkant Mulgaonkar, Marie M Morgievich
Compatible pairs of living kidney donors and their intended recipients can enter into kidney paired donation (KPD) and facilitate additional living donor kidney transplants (LDKTs). We examined 11 compatible pairs (the intended recipients and their intended, compatible donors) who participated in KPD, along with the recipients' 11 matched, exchange donors. The 11 pairs participated in 10 separate exchanges (3 were multi-center exchanges) that included 33 total LDKTs (22 additional LDKTs). All the intended donors were blood group O and female, with a mean living kidney donor profile index (LKDPI) of 27...
March 25, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/28340844/anatomic-diversity-encountered-during-laparoscopic-hand-assisted-transperitoneal-donor-nephrectomy-a-case-report-of-complete-caval-duplication
#16
S L Kirecci, M Demir, M Ilgi, M Battal, A I Dokucu, A Unsal
INTRODUCTION: Laparoscopic donor nephrectomy is widely used to retrieve a kidney for transplantation. Preoperative evaluation of the donor is of crucial importance to the recipient. In particular, vascular anatomy should be assessed with the help of modern imaging modalities. We present a hand-assisted laparoscopic nephrectomy of a kidney donor with a complete duplex vena cava. CASE REPORT: A 40-year-old male patient was admitted to our clinic as a kidney donor for his 20-year-old son...
April 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28340837/complications-in-donors-using-right-liver-graft-analysis-of-280-consecutive-cases
#17
M Özbilgin, T Ünek, T Egeli, C Ağalar, S Ozkardesler, E Karadeniz, H Ellidokuz, F Obuz, I Astarcıoğlu
INTRODUCTION: Living donor liver transplantation (LDLT) is performed with increasing frequency worldwide due to the shortage of donated organs. It is a life-saving procedure for the recipient, but, on the other hand, a major surgical procedure for healthy donors and it may cause morbidity and even mortality. PATIENTS AND METHODS: This research was completed at Dokuz Eylül University Faculty of Medicine Hospital General Surgery Department Liver Transplant Unit and included 280 cases (4 with simultaneous liver and kidney transplants from living donors) who underwent donor right hepatectomy for LDLT from June 2000 to June 2016...
April 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28340817/efficacy-and-safety-of-atg-fresenius-as-an-induction-agent-in-living-donor-kidney-transplantation
#18
M Yilmaz, T Ö Sezer, E Günay, I Solak, A Çeltik, C Hoşcoşkun, H Töz
BACKGROUND: Induction therapy is mostly recommended for deceased-donor transplantation, whereas it has some controversies in live-donor transplantation. In this study, we described the outcomes of live-donor renal transplant recipients who received ATG-Fresenius (ATG-F) induction. METHODS: Live-donor transplantations in patients over 18 years old with ATG-F induction between 2009 and 2015 were included. All patients received quadruple immunosuppression, one of which was ATG-F induction...
April 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28340810/comparison-of-two-different-inhalation-anesthetics-on-grafted-kidney-function-in-patients-undergoing-renal-transplantation-surgery-desflurane-or-sevoflurane
#19
M S Karadeniz, H S Ciftci, T Tefik, O Mammadov, H Yazıcı, I Nane, A Turkmen, F Oguz, K M Tugrul
BACKGROUND: Anesthetic management of patients during renal transplantation is vitally important for ensuring proper functioning of kidneys that have undergone ischemia-reperfusion damage. The goal of this prospective study was to compare the effects of 2 different inhalation agents (sevoflurane and desflurane) on grafted kidney function in renal transplantation surgery. METHODS: Sixty-five patients who were scheduled for living donor renal transplantation were enrolled in the study...
April 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28340803/evaluation-of-ureteral-stent-colonization-in-live-donor-renal-transplant-recipients
#20
M Sarier, M Demir, I Duman, Y Yuksel, A Demirbas
BACKGROUND: Ureteral stent insertion during kidney transplantation is a matter of debate. Stenting has been proven to reduce the risk of surgical complications. In addition, it has been reported to increase risks such as urinary tract infections especially after operation. Ureteral stent colonization (USC) is known to play a role in the pathogenesis of stent related-infections. The aim of this study was (1) to assess the frequency of USC and values of urine cultures in identifying colonizing bacteria; (2) to assess the importance of indwelling time for USC in live-donor renal transplant recipients; and (3) to evaluate the biomarker role of neutrophil-to-lymphocyte ratio (NLR) on USC...
April 2017: Transplantation Proceedings
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