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https://www.readbyqxmd.com/read/27921039/clinical-manifestation-and-management-of-adpkd-in-western-countries
#1
REVIEW
Claudia Sommerer, Martin Zeier
BACKGROUND: Autosomal dominant polycystic kidney disease (ADPKD) is the most common hereditary kidney disease in Western countries. The prevalence is between 2.4/10,000 and 3.9/10,000. ADPKD represents a systemic disease resulting in deterioration in renal function. Until now, mutations in two genes (PKD1 and PKD2) have been identified. Recently, the European Medicines Agency (EMA) approved the use of the vasopressin V2 receptor antagonist tolvaptan to slow the progression of cyst development and renal insufficiency connected with ADPKD in adult patients with chronic kidney disease stages 1-3 at initiation of treatment with evidence of rapidly progressing disease...
October 2016: Kidney Diseases
https://www.readbyqxmd.com/read/27921038/the-clinical-manifestation-and-management-of-autosomal-dominant-polycystic-kidney-disease-in-china
#2
REVIEW
Cheng Xue, Chen-Chen Zhou, Ming Wu, Chang-Lin Mei
BACKGROUND: Autosomal dominant polycystic kidney disease (ADPKD) is the most common monogenic hereditary kidney disease characterized by progressive enlargement of renal cysts. The incidence is 1-2‰ worldwide. Mutations in two genes (PKD1 and PKD2) cause ADPKD. Currently, there is no pharmaceutical treatment available for ADPKD patients in China. Summary: This review focused on advances in clinical manifestation, gene diagnosis, risk factors, and management of ADPKD in China. There is an age-dependent increase in total kidney volume (TKV) and decrease in renal function in Chinese ADPKD patients...
October 2016: Kidney Diseases
https://www.readbyqxmd.com/read/27920860/a-long-standing-external-iliac-artery-pseudoaneurysm-in-a-patient-with-a-history-of-a-failed-kidney-transplant
#3
Satyam Veean, Neil Patel, Daniel Lee, Hoang Vo, Eran Rotem
This is a case of a 66-year-old African American male with history of end stage renal disease due to polycystic disease and failed right kidney transplant. He presents with asymptomatic hematuria, and diagnostic angiography was performed which showed incidental anastomotic site pseudoaneurysm. Our patient had an unusual presentation of a pseudoaneurysm. Pseudoaneurysms associated with failed renal transplants are typically detected within weeks after transplantation and along with failure of the transplant...
December 2016: Radiology case reports
https://www.readbyqxmd.com/read/27911463/vascular-access-types-in-patients-starting-hemodialysis-after-failed-kidney-transplant-does-close-nephrology-follow-up-matter
#4
Naveed Ul Haq, Mohamed Said Abdelsalam, Mohammed Mahdi Althaf, Abdulrahman Ali Khormi, Hassan Al Harbi, Bader Alshamsan, Mamdouh Nasser Albaqumi, Dieter Clemens Broering, Lutfi Alkorbi, Hassan Ali Aleid
BACKGROUND: Native arteriovenous fistulae (AVFs) are preferred while central venous catheters (CVCs) are least suitable vascular access (VA) in patients requiring hemodialysis (HD). Unfortunately, around 80% of patients start HD with CVCs. Late referral to nephrologist is thought to be a factor responsible for this. We retrospectively analyzed the types of VA at HD initiation in renal transplant recipients followed by nephrologists with failed transplant. If early referral to nephrologist improves AVF use, these patients should have higher prevalence of AVF at HD initiation...
November 28, 2016: Journal of Vascular Access
https://www.readbyqxmd.com/read/27900974/disseminated-mycobacteria-chelonae-infection-in-a-kidney-pancreas-transplant-recipient-a-case-report-and-review-of-the-literature
#5
Shafi Malik, Ananda Ghosh, Shahid Husain
A 40-year-old male with a long-standing history of type 1 diabetes with end-stage renal failure underwent combined kidney-pancreas (KP) transplant from a standard criteria donor. Post-operative course was uncomplicated with good primary function of both transplant grafts. Induction was with thymoglobulin and maintenance immunosuppression was with tacrolimus, mycophenolate mofetil and prednisolone. Nine weeks post-transplant, the patient developed dysfunction of both grafts. Panel reactive antibody testing revealed that the patient had developed a de novo donor-specific antibody and considering an antibody-mediated rejection the patient was treated with intravenous pulse methyl prednisone 500 mg ×3 doses, IV immunoglobulin 2 mg/kg in two divided doses, and ATG 7 mg/kg (total dose of 700 mg)...
November 2016: Saudi Journal of Kidney Diseases and Transplantation
https://www.readbyqxmd.com/read/27900108/high-dose-chemotherapy-with-autologous-peripheral-blood-stem-cell-transplantation-for-choriocarcinoma-a-case-report-and-literature-review
#6
Eiko Yamamoto, Kaoru Niimi, Kayo Fujikake, Tetsuya Nishida, Makoto Murata, Ayako Mitsuma, Yuichi Ando, Fumitaka Kikkawa
Choriocarcinoma is a malignant gestational trophoblastic neoplasia (GTN) and one of the curable types of gynecological cancer. However, 10% of choriocarcinoma patients have a poor prognosis, particularly when they have metastasis, apart from pulmonary metastasis, or do not go into remission by the second chemotherapeutic regimen. We herein present the case of a 36-year-old patient who had choriocarcinoma with metastases to the lungs, liver and kidneys. The 5th and 6th regimens with cisplatin for choriocarcinoma failed and the patient developed brain metastases...
November 2016: Molecular and Clinical Oncology
https://www.readbyqxmd.com/read/27875647/what-pacemakers-can-teach-us-about-the-ethics-of-maintaining-artificial-organs
#7
Katrina Hutchison, Robert Sparrow
One day soon it may be possible to replace a failing heart, liver, or kidney with a long-lasting mechanical replacement or perhaps even with a 3-D printed version based on the patient's own tissue. Such artificial organs could make transplant waiting lists and immunosuppression a thing of the past. Supposing that this happens, what will the ongoing care of people with these implants involve? In particular, how will the need to maintain the functioning of artificial organs over an extended period affect patients and their doctors and the responsibilities of those who manufacture such devices? Drawing on lessons from the history of the cardiac pacemaker, this article offers an initial survey of the ethical issues posed by the need to maintain and service artificial organs...
November 2016: Hastings Center Report
https://www.readbyqxmd.com/read/27866309/osteoporosis-in-patients-with-diabetes-after-kidney-transplantation
#8
REVIEW
Elvira O Gosmanova, Aidar R Gosmanov
Preexisting diabetes increases risk of fractures after kidney transplantation (KT). However, little is known about mechanisms and prevention of increased fragility in these patients. Pathophysiology of osteoporosis after KT is complex and characterized by high prevalence of adynamic bone disease. Despite high prevalence of preexisting diabetes in KT recipients, diabetes patients were underrepresented in the studies that explored mechanisms and treatments of osteoporosis after KT. Therefore, caution should be exercised before considering conventional fracture prevention strategies in this unique group of patients...
November 19, 2016: Reviews in Endocrine & Metabolic Disorders
https://www.readbyqxmd.com/read/27862962/effect-of-replacing-race-with-apolipoprotein-l1-genotype-in-calculation-of-kidney-donor-risk-index
#9
B A Julian, R S Gaston, W M Brown, A M Reeves-Daniel, A K Israni, D P Schladt, S O Pastan, S Mohan, B I Freedman, J Divers
Renal allografts from deceased African Americans with two apolipoprotein L1 gene (APOL1) renal-risk variants fail sooner than kidneys from donors with fewer variants. Kidney Donor Risk Index (KDRI) was developed to evaluate organ offers by predicting allograft longevity and includes African American race as a risk factor. Substituting APOL1 genotype for race may refine the KDRI. For 622 deceased African American kidney donors, we applied 10-fold cross-validation approach to estimate contribution of APOL1 variants to a revised KDRI...
November 14, 2016: American Journal of Transplantation
https://www.readbyqxmd.com/read/27805505/challenges-for-renal-retransplant-an-overview
#10
Mohamed Adel Bakr, Ahmed Abdelfattah Denewar, Mohamed Hamed Abbas
Despite many achievements in renal transplant in the past few years regarding immunosuppression and tissue matching, the rates of early and late graft loss and return to dialysis are still high. Many of those with primary graft failure will be listed for a kidney retransplant, as this allows for better quality of life than dialysis. Many challenges face those requiring renal retransplant, including first graft nephrectomy and whether site of retransplant should be ipsilateral or contralateral, whether to conduct preemptive retransplant or wait while on dialysis, additional immunologic factors, immunosuppression after retransplant, cancer risk, BK virus infection, and retransplant in pediatrics...
November 2016: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/27798517/incidence-and-indications-for-late-allograft-pancreatectomy-while-on-continued-immunosuppression
#11
Sandesh Parajuli, Jon Odorico, Brad C Astor, Arjang Djamali, Hans Sollinger, Robert Redfield, Dixon Kaufman, Didier A Mandelbrot
BACKGROUND: There are limited data about the incidence and indications for late allograft pancreatectomy while on continued immunosuppression for functional kidney allografts. METHODS: We analyzed recipients of simultaneous pancreas and kidney (SPK) and pancreas after kidney (PAK) transplants between January 1994 and July 2013. Patients with functional kidney but failed pancreas allografts after 90 days were included. RESULTS: Out of 1022 SPK or PAK recipients, 246 satisfied these criteria...
October 28, 2016: Transplantation
https://www.readbyqxmd.com/read/27796621/fatal-disseminated-cowpox-virus-infection-in-an-adolescent-renal-transplant-recipient
#12
Paul Gazzani, Joanna E Gach, Isabel Colmenero, Jeff Martin, Hugh Morton, Kevin Brown, David V Milford
BACKGROUND: A 17-year-old boy on long-term immunosuppression following renal transplantation for chronic kidney disease (CKD), the result of dysplastic kidneys, initially presented with a swelling in his neck while attending hospital for an unrelated problem. A clinical diagnosis of tonsillitis was made, and he was treated with broad-spectrum antibiotics. Over a few days, his condition deteriorated, and he developed multiple vesicopustular skin lesions and required an emergency tonsillectomy due to respiratory distress...
October 28, 2016: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
https://www.readbyqxmd.com/read/27776143/defining-priorities-for-future-research-results-of-the-uk-kidney-transplant-priority-setting-partnership
#13
Simon R Knight, Leanne Metcalfe, Katriona O'Donoghue, Simon T Ball, Angela Beale, William Beale, Rachel Hilton, Keith Hodkinson, Graham W Lipkin, Fiona Loud, Lorna P Marson, Peter J Morris
BACKGROUND: It has been suggested that the research priorities of those funding and performing research in transplantation may differ from those of end service users such as patients, carers and healthcare professionals involved in day-to-day care. The Kidney Transplant Priority Setting Partnership (PSP) was established with the aim of involving all stakeholders in prioritising future research in the field. METHODS: The PSP methodology is as outlined by the James Lind Alliance...
2016: PloS One
https://www.readbyqxmd.com/read/27770258/kidney-transplantation-fails-to-provide-adequate-growth-in-children-with-chronic-kidney-disease-born-small-for-gestational-age
#14
Doris Franke, Rena Steffens, Lena Thomas, Leo Pavičić, Thurid Ahlenstiel, Lars Pape, Jutta Gellermann, Dominik Müller, Uwe Querfeld, Dieter Haffner, Miroslav Živičnjak
BACKGROUND: Children with chronic kidney disease are frequently born small for gestational age (SGA) and prone to disproportionately short stature. It is unclear how SGA affects growth after kidney transplantation (KTx). METHODS: Linear growth (height, sitting height, and leg length) was prospectively investigated in a cohort of 322 pediatric KTx recipients, with a mean follow-up of 4.9 years. Sitting height index (ratio of sitting height to total body height) was used to assess body proportions...
October 21, 2016: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
https://www.readbyqxmd.com/read/27762063/peritoneal-dialysis-in-patients-with-failed-kidney-transplant-single-centre-experience
#15
Saurabh Chaudhri, Alice A Thomas, Nasreen Samad, Stanley L Fan
AIM: To determine if patients with failing kidney transplants who opt to have peritoneal dialysis (PD) have poor short-term PD technique survival and increased rates of peritonitis. METHODS: We performed a retrospective analysis comparing 50 consecutive patients starting PD after a failed kidney transplant to 93 incident patients starting PD (matching for age, gender, diabetes causing renal failure, ethnicity and year of starting PD). RESULTS: The mean follow-up period was 26 months...
October 20, 2016: Nephrology
https://www.readbyqxmd.com/read/27755502/primary-human-renal-derived-tubular-epithelial-cells-fail-to-recognize-and-suppress-bk-virus-infection
#16
Hanneke de Kort, Kirstin M Heutinck, Jurjen M Ruben, Alessa E Valverde da Silva, Katja C Wolthers, Jörg Hamann, Ineke J M Ten Berge
BACKGROUND: BK polyomavirus (BKV)-associated nephropathy is a threat to kidney allograft survival affecting up to 15% of renal transplant patients. Previous studies revealed that tubular epithelial cells (TEC) show a limited response towards BKV infection. Here we investigated the interplay between BKV and TEC in more detail. In particular, we questioned whether BKV suppresses and/or evades antiviral responses. METHODS: Human primary tubular epithelial cells (TEC) and peripheral blood mononuclear cells were infected with BKV Dunlop strain or other viruses...
October 17, 2016: Transplantation
https://www.readbyqxmd.com/read/27752765/acute-kidney-transplant-rejection-mediated-by-angiotensin-ii-type-1-receptor-antibodies-in-a-pediatric-hyperimmune-patient
#17
Isabella Guzzo, Federica Morolli, Francesca Diomedi Camassei, Antonina Piazza, Elvira Poggi, Luca Dello Strologo
BACKGROUND: Several cases of severe antibody-mediated rejection (AMR) secondary to antibodies against the angiotensin II type 1 receptor (AT1R-Ab) have been described with variable outcome. CASE-DIAGNOSIS/TREATMENT: We report the case of a 13-year-old boy whose first kidney transplant failed due to steroid-resistant acute cellular rejection, with the subsequent development of sensitization. He received a second kidney transplant which was complicated by early humoral rejection, with weakly positive staining for the complement degradation product C4d...
January 2017: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
https://www.readbyqxmd.com/read/27742385/costimulatory-blockade-and-use-of-mtor-inhibitors-avoiding-injury-part-2
#18
REVIEW
David Wojciechowski, Flavio Vincenti
Kidney transplantation immunosuppression relies on a calcineurin inhibitor backbone. Calcineurin inhibitors have reduced early-acute rejection rates but failed to improve long-term allograft survival. Their nephrotoxicity has shifted the focus of investigation to calcineurin inhibitor-free regimens. Costimulation blockade with belatacept, a second generation, higher avidity variant of CTLA4-Ig, has emerged as part of a calcineurin inhibitor-free regimen. Belatacept has demonstrated superior glomerular filtration rate compared with calcineurin inhibitors albeit with an increased risk of early and histologically severe rejection...
September 2016: Advances in Chronic Kidney Disease
https://www.readbyqxmd.com/read/27742346/a-single-center-experience-of-allograft-nephrectomies-following-kidney-transplantation
#19
F Toth, G Zadori, R Fedor, L Illesy, M Szabo-Pap, Z Kanyari, D A Kovacs, L Asztalos, B Nemes
INTRODUCTION: Approximately 10% of renal allografts fail during the first year after kidney transplantation (KT) and 3%-5% thereafter yearly. The indication and timing of allograft nephrectomy (AN) is still uncertain in some cases. The aim of this study was to reveal the ratio, etiology, and complications of AN at our center. MATERIAL AND METHODS: This is a retrospective study of all patients who underwent KT at our center between January 1, 2004 and December 31, 2014...
September 2016: Transplantation Proceedings
https://www.readbyqxmd.com/read/27733136/inactivation-of-the-tumor-suppressor-gene-von-hippel-lindau-vhl-in-granulocytes-contributes-to-development-of-liver-hemangiomas-in-a-mouse-model
#20
Hannah L Bader, Tien Hsu
BACKGROUND: Mutations in the tumor suppressor gene von Hippel-Lindau (VHL) underlie a hereditary cancer syndrome-VHL disease-and are also frequently observed in sporadic renal cell carcinoma of the clear cell type (ccRCC). VHL disease is characterized by malignant and benign tumors in a few specific tissues, including ccRCC, hemangioblastoma and pheochromocytoma. The etiology of these tumors remains unresolved. METHODS: Conditional inactivation of the VHL gene in mouse (Vhlh) was generated to examine the pathophysiological role of the VHL gene function...
October 12, 2016: BMC Cancer
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