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living donor renal transplantation

Musallam Abukhalil, Osama Mehjez, Mohammed Aladdam, Bettina Bottcher, Sobhi Skaik, Mohammed Matter
BACKGROUND: In 2013, al-Shifa Hospital, the largest hospital in the Gaza Strip, introduced an assessment programme for potential kidney donors on the basis of medical and radiological evaluation. The aims of this study and an associated clinical audit were to examine the final outcome of the potential live kidney donors assessment programme, to review the findings and determine the level of accuracy of the radiological evaluations, to assess the completeness and standard of radiological record keeping, and to evaluate adherence to guidelines...
February 21, 2018: Lancet
Yu Huang, Mitsuhisa Takatsuki, Akihiko Soyama, Masaaki Hidaka, Shinichiro Ono, Tomohiko Adachi, Takanobu Hara, Satomi Okada, Takashi Hamada, Susumu Eguchi
BACKGROUND Liver transplantation is indicated for patients with Wilson's disease (WD) who present either with acute liver failure or with end-stage liver disease and severe hepatic insufficiency as the first sign of disease. However, almost all reported cases have been treated with death donor liver transplantation. Here we report the case of a patient with WD associated with fulminant hepatic failure (WD-FHF) who underwent living donor liver transplantation (LDLT). CASE REPORT A 17-year-old female was diagnosed with WD-FHF based on high uric copper (10 603 μg/day, normal <100 μg/day), low serum ceruloplasmin (15 mg/dL, normal >20 mg/dL) and Kayser-Fleischer (K-F) corneal ring, and acute liver failure (ALF), acute renal failure (ARF) and grade 2 hepatic encephalopathy (HE)...
March 17, 2018: American Journal of Case Reports
Joke I Roodnat, Anneke M E de Mik-van Egmond, Wesley J Visser, Stefan P Berger, Wilbert A G van der Meijden, Felix Knauf, Madelon van Agteren, Michiel G H Betjes, Ewout J Hoorn
Background: Enteric hyperoxaluria due to malabsorption may cause chronic oxalate nephropathy and lead to end-stage renal disease. Kidney transplantation is challenging given the risk of recurrent calcium-oxalate deposition and nephrolithiasis. Methods: We established a protocol to reduce plasma oxalic acid levels peritransplantation based on reduced intake and increased removal of oxalate. The outcomes of 10 kidney transplantation patients using this protocol are reported...
December 2017: Transplantation Direct
Shunta Hori, Mitsuru Tomizawa, Fumisato Maesaka, Takuya Owari, Yosuke Morizawa, Yasushi Nakai, Makito Miyake, Tatsuo Yoneda, Nobumichi Tanaka, Katsunori Yoshida, Kiyohide Fujimoto
BACKGROUND: Page kidney phenomenon is caused by strong renal parenchymal compression and leads to renal hypoperfusion and microvascular ischemia, resulting in renal dysfunction and hypertension. Although the development of Page kidney phenomenon in allograft is rare, most of its cases are induced by allograft biopsy or trauma. We observed a case of Page kidney phenomenon that was induced by unusual causes immediately after kidney transplantation. CASE PRESENTATION: A 66-year-old man, whose wife donated a kidney, underwent ABO-compatible living kidney transplantation...
March 13, 2018: BMC Nephrology
Khawar Abbas, Muhammed Mubarak, Mirza Naqi Zafar, Wajiha Musharraf, Mehjabeen Imam, Tahir Aziz, Adibul Hassan Rizvi
OBJECTIVES: Plasma cell-rich acute rejection is an aggressive form of acute rejection that occurs late after transplant and is usually resistant to standard antirejection therapy. This study reports the safety, efficacy, and outcomes of plasma cell-rich acute rejection after treatment with bortezomib, a proteasome inhibitor, in 10 patients after a first living-related renal transplant. MATERIALS AND METHODS: Plasma cell-rich acute rejection was diagnosed using the 2007 Banff classification...
March 9, 2018: Experimental and Clinical Transplantation
Toshihiro Yasui, Tatsuya Suzuki, Fujio Hara, Shunsuke Watanabe, Naoko Uga, Atsuki Naoe, Yasuhiro Kondo
OBJECTIVES: In pediatric patients, renal dysfunction after living-donor liver transplant is a major issue that is difficult to evaluate. Recently, predictive equations for Japanese children have been introduced. MATERIALS AND METHODS: We conducted a retrospective study by prospectively collecting data on 26 patients under 16 years old who underwent living-donor liver transplant between June 2004 and March 2015. Serum creatinine and cystatin C levels were measured...
March 9, 2018: Experimental and Clinical Transplantation
Junya Hashimoto, Yuko Hamasaki, Yusuke Takahashi, Mai Kubota, Taketo Yanagisawa, Yoshihiro Itabashi, Masaki Muramatsu, Takeshi Kawamura, Naonori Kumagai, Yoko Ohwada, Ken Sakai, Seiichiro Shishido
AIM: Epstein syndrome is a hereditary disease characterised by macrothrombocytopaenia and progressive nephritis. The abnormality of the MYH9 gene has a strong relationship to the severity of the disease. Severe Epstein syndrome progresses to end-stage renal disease rapidly after adolescence. There is no established therapy. We sought to clarify appropriate management of Epstein syndrome nephropathy. METHODS: Epstein syndrome patients who underwent renal transplantation at our institution between March 2009 and March 2017 were enrolled...
March 13, 2018: Nephrology
Damla Ateş, Fatma Cebeci
Obesity, which has become an increasing problem worldwide, poses a risk for kidney transplant recipients both before and after surgery. In this literature review, we studied the effects of obesity before and after kidney transplant. There are numerous studies and different opinions on the effects of obesity on graft function before and after transplant. Obesity prolongs surgery time and the ischemic process. A large cohort study of 11 836 recipients noted a close association between body mass index and delayed renal transplant and delayed graft function...
March 2018: Experimental and Clinical Transplantation
B Handan Özdemir, F Nurhan Özdemir, Pelin Börcek, Çiğdem Sercan, Gökçe Özdemir, Ebru H Ayvazoğlu Soy, Mehmet Haberal
OBJECTIVES: Transplant vasculopathy is a significant predictor of poor outcome. We investigated whether age or pretransplant renal arterial vasculopathy of grafted kidneys affected allograft survival. MATERIALS AND METHODS: This study included 148 recipients and their donors. All donors underwent pretransplant renal arterial biopsy, with renal artery vascular score determined for each artery. Chronic rejection and graft loss were noted for all patients. RESULTS: Variable grades of pretransplant renal arterial lesions were noted in 103 donors (69...
March 2018: Experimental and Clinical Transplantation
Atsushi Aikawa, Masaki Muramatsu, Yusuke Takahashi, Yuko Hamasaki, Junya Hashimoto, Mai Kubota, Takeshi Kawamura, Yoshihiro Itabashi, Yoiji Hyodou, Seiichiro Shishido
During pediatric kidney transplant, surgical challenges occasionally occur. In particular, vascular anastomosis should be considered for children with small body weight < 12 kg, multiple renal arteries, vascular anomaly, and inferior vena cava occlusion. In pediatric patients, a living-donor renal graft is usually donated from a parent. Therefore, the renal artery and vein are too large to be anastomosed with the recipient's internal iliac artery and external iliac vein. In children who are > 12 kg, the renal artery and vein could be anastomosed with the external iliac artery and the external iliac vein...
March 2018: Experimental and Clinical Transplantation
Dieter Adelmann, Leonie Bicknell, Claus U Niemann, John Feiner, Garrett R Roll, Lyle Burdine, Elizabeth L Whitlock
BACKGROUND: During kidney transplantation, intraoperative fluid management can affect post-transplant graft function. It is unclear whether or not central venous pressure (CVP) monitoring is required to guide fluid therapy during kidney transplantation. METHODS: We compared post-transplant graft function in recipients of living donor kidney transplants between August 2006 and March 2009 based on the use or absence of intraoperative CVP monitoring. Graft function, assessed using the creatinine reduction ratio on postoperative day 2 (CCR2), was evaluated by multivariable linear regression analysis and in a propensity-matched cohort...
March 11, 2018: Clinical Transplantation
Jesse D Schold, Stuart M Flechner, Emilio D Poggio, Joshua J Augustine, David A Goldfarb, John R Sedor, Laura D Buccini
BACKGROUND: The effects of underlying noncodified risks are unclear on the prognosis of patients with end-stage renal disease (ESRD). We aimed to evaluate the association of residential area life expectancy with outcomes and processes of care for patients with ESRD in the United States. STUDY DESIGN: Retrospective cohort study. SETTING & PARTICIPANTS: Adult patients with incident ESRD between 2006 and 2013 recorded in the US Renal Data System (n=606,046)...
March 7, 2018: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
Diogo Buarque Cordeiro Cabral, Tainá Veras de Sandes-Freitas, José Osmar Medina-Pestana, Gianna Mastroianni-Kirsztajn
BACKGROUND Initially described as a relatively benign condition, recent studies report graft loss in up to 50% of the patients with post-transplant IgA nephropathy. There is no evidence for the best therapeutic approach, and prognostic factors remain to be elucidated. MATERIAL AND METHODS Single center retrospective analysis of patients >12 years old, with clinically relevant post-transplant IgA nephropathy (proteinuria ≥1.0 g/g and/or graft dysfunction) and ≥6 months follow-up after diagnosis (n=47)...
March 9, 2018: Annals of Transplantation: Quarterly of the Polish Transplantation Society
Therese Adrian, Mads Hornum, Frank Eriksson, Jesper M Hansen, Katrine Pilely, Peter Garred, Bo Feldt-Rasmussen
Background: Patients with end-stage renal disease (ESRD) have high morbidity and mortality rates, with cardiovascular diseases and infections being the major causes of death. Mannose-binding lectin (MBL) has been suggested to play a protective role in this regard. The aim of this study was to investigate a possible clinical association of MBL genotypes (MBL2) with outcome among patients on dialysis or with a functioning graft. Methods: A total of 98 patients with ESRD accepted for living-donor renal transplantation or on the waiting list for transplantation were included and prospectively followed for an average of 9 years (range 7...
March 3, 2018: Nephrology, Dialysis, Transplantation
C L Jay, M M Abecassis
For decades, evidence has been available demonstrating the superiority of kidney transplantation for patients with end-stage renal disease (ESRD) compared with dialysis in terms of improved survival, better quality of life, and long-term cost-effectiveness.(1, 2) Yet, many barriers continue to exist to increasing patient access to kidney transplant through utilization of higher risk deceased donor kidney transplants (DDKT) or blood type (ABO) or immunologically (HLA) incompatible living donor kidney transplants (LDKT)...
March 7, 2018: American Journal of Transplantation
Geraldine Miller, Heidi Schaefer, Sandra Yoder, Rachel Miller, Patricia Winokur, Karen Kotloff, David Klassen, Michael Wierzbicki, Cyrille Amegashie, Kathryn Edwards
BACKGROUND: Solid organ transplant recipients are at increased risk for reactivation of herpes zoster, or shingles, and have a higher frequency of serious complications including post-herpetic neuralgia. A live, attenuated shingles vaccine is effective and approved for individuals 50 years and older. The vaccine is contraindicated following transplantation but may be used in patients with renal failure. Utilization of the vaccine has been poor in patients with end-stage renal disease, including those awaiting transplant, due to concerns for safety, efficacy, and potential sensitization prior to transplant...
March 7, 2018: Transplant Infectious Disease: An Official Journal of the Transplantation Society
Federica Vernuccio, Raj Gondalia, Susan Churchill, Mustafa R Bashir, Daniele Marin
Proper pre- and post-transplant diagnostic imaging work-up is fundamental in ensuring a successful outcome for renal transplantation. Despite exposure to ionizing radiation, CT has high spatial resolution and is a widely available and fast imaging technique. CT is performed routinely to delineate the anatomy of the kidney, relevant vasculature, and urinary collecting system in the living donor, to assess the iliac vessels in potential recipients prior to surgery, and to assess early and late-term post-transplant complications...
March 5, 2018: Abdominal Radiology
Mehmet Sarier, Ibrahim Duman, Yucel Yuksel, Sabri Tekin, Meltem Demir, Fatih Arslan, Osman Ergun, Alim Kosar, Asuman Havva Yavuz
Allograft lithiasis is a rare urologic complication of renal transplantation (RT). Our aim is to present our experience with minimally invasive surgical treatment of allograft lithiasis in our series of live-donor renal transplant recipients. In a retrospective analysis of 3758 consecutive live-donor RTs performed in our center between November 2009 and January 2017, the results of minimally invasive surgery for the treatment of renal graft lithiasis diagnosed at follow-up were evaluated. Twenty-two (0.58%) patients underwent minimally invasive surgery for renal graft lithiasis...
February 26, 2018: Urolithiasis
Mohamed S Al Riyami, Sulaiman Al Saidi, Badria Al Ghaithi, Anisa Al Maskari, Sadiq Lala, Nabil Mohsin, Lekha Hirshikesan, Naifain Al Kalbani
Objectives: This study sought to report 22 years experience in pediatric kidney transplantation in Oman. Methods: Electronic charts of all Omani children below 13 years of age who received a kidney transplant from January 1994 to December 2015 were reviewed. Data collected included patient demographics, etiology of end-stage kidney disease, modality and duration of dialysis, donor type, complication of kidney transplantation (including surgical complications, infections, graft rejection) graft and patient survival, and duration of follow-up...
January 2018: Oman Medical Journal
L Rostaing
Renal transplantation is the best option for patients with end stage renal failure, since it significantly improves their duration and quality of life. The number of patients waiting for a kidney transplant continues to increase while the overall rate of organ procurement in France is stable. The graft shortage is worsening, as is the waiting time on list. Identifying the causes of this crisis and discussing the various options for addressing the kidney graft shortage is the aim of this talk. Among the solutions: (i) improving identification of potential donors through a national and hospitals policy to promulgate organ donation and understanding better the grounds for refusal; (ii) using infusion machines for all grafts with extended criteria; (iii) developing transplantation programs from deceased donors after cardiac arrest; (iv) developing transplantation programs from living donors...
June 2017: Néphrologie & Thérapeutique
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