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Nephrectomy after transplant failure

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https://www.readbyqxmd.com/read/28631039/graft-nephrectomy-in-children
#1
Benedict L Phillips, Chris J Callaghan
Kidney transplantation is recognised as the gold standard treatment of end-stage renal disease in most children, with excellent graft survival rates. When graft failure occurs, renal transplant recipients (RTRs) have the option of removal of the transplant (graft nephrectomy [GN]), or leaving the failed transplant in situ. The aims of this review are to discuss the indications for GN, surgical techniques, outcomes after GN (including risks of allosensitisation and the impact on subsequent transplants), and the possible role of routine GN in the asymptomatic RTR with a failed renal allograft...
June 19, 2017: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
https://www.readbyqxmd.com/read/28597060/-early-bilateral-nephrectomy-in-neonatal-autosomal-recessive-polycystic-kidney-disease-improved-prognosis-or-unnecessary-effort
#2
REVIEW
S Riechardt, M Koch, J Oh, M Fisch
BACKGROUND: Neonatal autosomal recessive polycystic kidney disease (ARPKD) is associated with giant kidneys, lung hypoplasia, pulmonal hypertension, and end-stage renal failure. Depending on the study, mortality is reported to range between 20 and 80%. OBJECTIVES: Does bilateral nephrectomy improve survival? PATIENTS AND METHODS: Between 2010 and 2016, we treated 7 children with prenatally diagnosed ARPKD. All had a planned delivery by cesarean section...
June 8, 2017: Der Urologe. Ausg. A
https://www.readbyqxmd.com/read/28540840/living-donor-kidney-transplant-in-a-patient-with-type-b-mayer-rokitansky-k%C3%A3-ster-hauser-syndrome-reconstructed-vagina-and-abnormal-pelvic-vessels-a-case-report
#3
Mariarosaria Campise, Mariano Ferraresso, Evaldo Favi, Claudio Beretta, Caterina Colico, Piergiorgio Messa
Mayer-Rokitansky-Küster-Hauser syndrome is a rare disorder consisting of vaginal aplasia and other müllerian duct abnormalities. Urinary tract malfor-mations possibly leading to renal failure are also common. For these patients, kidney transplant remains the best option. However, aberrant anatomy and scarring from previous operations may actually preclude successful implantation of the graft. In this setting, careful pretransplant evaluation with high-resolution imaging studies and multidisciplinary planning are mandatory...
May 22, 2017: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/28396741/renal-allograft-granulomatous-interstitial-nephritis-observations-of-an-uncommon-injury-pattern-in-22-transplant-recipients
#4
Alton B Farris, Carla L Ellis, Thomas E Rogers, W James Chon, Anthony Chang, Shane M Meehan
Background: Granulomatous interstitial nephritis (GIN) is uncommon in native kidneys, and descriptions in allografts are few. We report clinical and pathologic findings in 22 allograft recipients with GIN identified in renal allograft biopsies and nephrectomies. Methods: Renal allografts with GIN were retrieved from the pathology files of two academic medical centers. Available clinical and pathologic data were compiled retrospectively for a 23-year period. Results: GIN was present in 23 specimens from 22 patients (15 males and 7 females) with allograft dysfunction [serum creatinine averaged 3...
April 2017: Clinical Kidney Journal
https://www.readbyqxmd.com/read/28261895/bilateral-native-nephrectomy-reduces-systemic-oxalate-level-after-combined-liver-kidney-transplant-a-case-report
#5
Vincenzo Villani, Neena Gupta, Nahel Elias, Parsia A Vagefi, James F Markmann, Elahna Paul, Avram Z Traum, Heidi Yeh
Primary hyperoxaluria type 1 (PH1) is a rare liver enzymatic defect that causes overproduction of plasma oxalate. Accumulation of oxalate in the kidney and subsequent renal failure are fatal to PH1 patients often in pediatric age. Combined liver and kidney transplantation is the therapy of choice for end-stage renal disease due to PH1. Levels of plasma oxalate remain elevated for several months after liver transplantation, as the residual body oxalate is slowly excreted. Patients with persistent hyperoxaluria after transplant often require hemodialysis, and accumulation of residual oxalate in the kidney can induce graft dysfunction...
May 2017: Pediatric Transplantation
https://www.readbyqxmd.com/read/28104114/re-evaluating-cut-off-points-for-the-expansion-of-deceased-donor-criteria-for-kidney-transplantation-in-japan
#6
Y Nakagawa, M Ikeda, T Ando, M Tasaki, K Saito, K Takahashi, A Aikawa, M Kikuchi, K Akazawa, Y Tomita
BACKGROUND: A shortage of donors poses a serious problem for organ transplantation around the world. In response, the concept of the expanded criteria donor (ECD) has been defined to include donors with traditionally less favorable characteristics. That definition has now been accepted and is being applied in kidney transplantation in the United States and Europe. However, the ECD has not yet been defined for deceased donor kidney transplantation in Japan. PATIENTS AND METHODS: We analyzed data on graft survival and relevant risk factors in patients who received deceased donor kidney transplants through the East Japan Branch of the Japan Organ Transplant network (n = 1051)...
January 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/27805505/challenges-for-renal-retransplant-an-overview
#7
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/27448016/renal-transplantation-technical-aspects-diagnosis-and-management-of-early-and-late-urological-complications
#8
REVIEW
Francesco Greco, Stefano Alba, Paolo Fornara, Vincenzo Mirone
INTRODUCTION: Renal transplantation (RT) represents actually the most effective therapy in patients with end-stage renal failure as it is cost effective, allows for a normal life style and reduces the risk of mortality from dialysis related complications. The purpose of the present review is to update the recent published literature regarding the technical aspects, diagnosis and the urological complications associated with renal transplantation. EVIDENCE ACQUISITION: A comprehensive literature review was performed using PubMed and Thomson-Reuters Web of Science between February 2014 and June 2016...
December 2016: Panminerva Medica
https://www.readbyqxmd.com/read/27447713/2-8-dihydroxyadenine-nephropathy-identified-as-cause-of-end-stage-renal-disease-after-renal-transplant
#9
Smiley Annie George, Sulaiman Al-Rushaidan, Issam Francis, Darius Soonowala, M R Narayanan Nampoory
Adenine phosphoribosyltransferase deficiency is a rare autosomal recessive disorder of uric acid metabolism that leads to formation and excretion of 2,8-dihydroxyadenine into urine. The low solubility of 2,8-dihydroxyadenine results in precipitation and formation of urinary crystals and renal stones. Patients with this disorder usually have recurrent nephrolithiasis and can develop nephropathy secondary to crystal precipitation in the renal parenchyma. The disease is most often underdiagnosed and can recur in renal transplant, causing graft failure...
July 22, 2016: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/27410399/recurrence-of-hyperoxaluria-and-kidney-disease-after-combined-intestine-kidney-transplantation-for-enteric-hyperoxaluria
#10
Burcin Ekser, Richard S Mangus, Chandrashekhar A Kubal, Jonathan A Fridell, John A Powelson, Santosh Nagaraju, Plamen Mihaylov, Carrie L Phillips, Romil Saxena, William C Goggins
BACKGROUND: Enteric hyperoxaluria (EH) occurs with a rate of 5-24% in patients with inflammatory bowel disease, ileal resection and modern bariatric surgery. The excessive absorption of calcium oxalate causes chronic kidney disease (CKD) in patients with EH. In the literature, a single experience was reported in combined intestine-kidney transplantation (CIKTx) in patients with CKD due to EH. METHODS: After a report of 2 successful cases of CIKTx in patients with EH and CKD, one was performed at our center in a 59-year-old Caucasian female who developed intestinal failure with total parenteral nutrition (TPN) dependence after a complication post-bariatric surgery...
2016: American Journal of Nephrology
https://www.readbyqxmd.com/read/27234776/abscess-of-native-kidney-caused-by-carbapenem-resistant-acinetobacter-baumannii-crab-in-renal-transplantation-a-case-report
#11
Y-M Choe, K-M Park, Y S Jeon, S G Cho, K C Hong, W Y Shin, J H Song
BACKGROUND: Abscess of native kidney is a rare postoperative event after renal transplantation. This report describes a case of back pain, fever and pyuria caused by carbapenem-resistant Acinetobacter baumannii (CRAB) in a patient who underwent renal-transplantation. CASE REPORT: A 40-year-old man, presenting with hypertension and renal failure, underwent renal transplantation 1 month previously. He developed sudden intense back pain and fever (39°C). There was normal blood flow in graft kidney but there were the swelling and cyst of right native kidney...
April 2016: Transplantation Proceedings
https://www.readbyqxmd.com/read/27234732/impact-of-pretransplant-panel-reactive-antibody-level-on-renal-graft-survival-in-patients-with-a-negative-crossmatch-and-no-donor-specific-antibody
#12
K W Jun, M H Kim, J K Hwang, S D Kim, S C Park, Y S Won, I S Moon, B H Chung, B S Choi, C W Yang, Y S Kim, J I Kim
BACKGROUND: Patients with high panel-reactive antibody (PRA) levels before transplantation tend to remain on the waiting list longer when considering cadaveric donor transplantation and have worse outcomes than those with lower PRA levels. This study investigated the impact of the pretransplantation PRA level on rejection and graft survival after kidney transplantation in patients with a negative crossmatch (CXM(-)) and no donor-specific antibody (DSA(-)). METHODS: We retrospectively analyzed 513 recipients of kidney allograft treated from January 2009 to April 2013...
April 2016: Transplantation Proceedings
https://www.readbyqxmd.com/read/26926543/national-trends-in-secondary-procedures-following-pediatric-pyeloplasty
#13
Geolani W Dy, Ryan S Hsi, Sarah K Holt, Thomas S Lendvay, John L Gore, Jonathan D Harper
PURPOSE: Although reported success rates after pediatric pyeloplasty to correct ureteropelvic junction are high, failure may require intervention. We sought to characterize the incidence and timing of secondary procedures after pediatric pyeloplasty using a national employer based insurance database. MATERIALS AND METHODS: Using the MarketScan® database we identified patients 0 to 18 years old who underwent pyeloplasty from 2007 to 2013 with greater than 3 months of postoperative enrollment...
April 2016: Journal of Urology
https://www.readbyqxmd.com/read/26915879/renal-squamous-cell-carcinoma-of-a-native-kidney-after-renal-transplant-a-case-report
#14
A Jakes, P Jani, M Menon, K Adams, M Edey, S Fleming, S Bhandari
BACKGROUND: Renal squamous cell carcinoma is a rare primary tumor of the kidney that rapidly invades local structures and has a poor prognosis. Presentation is usually nonspecific and is associated with renal stone disease and chronic infection. Immunosuppressed renal transplant recipients are more likely to develop a malignancy than the general population. Squamous cell carcinoma of the kidney in the context of a renal transplant and long-term immunosuppression has not previously been described in the literature...
January 2016: Transplantation Proceedings
https://www.readbyqxmd.com/read/26804756/current-paradigm-for-ischemia-in-kidney-surgery
#15
REVIEW
Maria C Mir, Nicola Pavan, Dipen J Parekh
PURPOSE: Partial nephrectomy is the accepted standard of care for treatment of patients with small renal masses. The primary goal while performing partial nephrectomy is cancer control with a secondary important goal of maximizing renal function preservation with minimal perioperative morbidity. Recent studies have highlighted the importance of renal parenchymal quality and quantity postoperatively rather than duration of ischemia in determining long-term renal function. We review the available data regarding perioperative renal function optimization with special interest in ischemia during partial nephrectomy, highlighting the controversies and establishing future lines of investigation...
June 2016: Journal of Urology
https://www.readbyqxmd.com/read/26680071/patients-after-kidney-allograft-failure-immunologic-and-nonimmunologic-considerations
#16
REVIEW
S Marinaki, C Skalioti, J Boletis
Patients returning to dialysis after kidney transplant failure represent approximately 5%-15% of the population starting hemodialysis. These patients exhibit a high risk of morbidity and mortality attributed mainly to the exposure to immunosuppressive medications and to a uremic environment. The purpose of this paper was to review data regarding survival after renal allograft failure and the optimal management of patients before returning to dialysis. Moreover, issues surrounding nephrectomy after renal allograft failure, the tapering of immunosuppression and the possibility of retransplantation are examined, because they seem to be crucial for patient survival and the quality of life...
November 2015: Transplantation Proceedings
https://www.readbyqxmd.com/read/26680051/graft-survival-in-patients-with-polycystic-kidney-disease-with-nephrectomy-of-native-kidney-pretransplant
#17
J H García-Rubio, J Carrasco Valiente, J P Campos Hernández, J Ruiz García, J Márquez López, J C Regueiro López, R Cano Castiñeira, M V Pendón Ruiz de Mier, M J Requena Tapia
INTRODUCTION: Autosomal-dominant polycystic disease (ADPKD) represents 5%-10% of cases of end-stage renal failure. However, management of these patients in terms of whether or not to perform a transplant and optimal timing remains controversial. The objective of our analysis was to evaluate graft survival in patients with ADPKD in which we conduct pretransplant nephrectomy. METHODS: This retrospective study including renal transplant patients secondary to ADPKD in our hospital between January 2000 and December 2012...
November 2015: Transplantation Proceedings
https://www.readbyqxmd.com/read/26664431/acute-oxalate-nephropathy-following-kidney-transplantation-report-of-three-cases
#18
Diana Taheri, Alaleh Gheissari, Pooria Shaabani, Seyed Reza Tabibian, Mojgan Mortazavi, Shiva Seirafian, Alireza Merrikhi, Mehdi Fesharakizadeh, Shahaboddin Dolatkhah
Calcium oxalate (CaOx) crystal deposition is a common finding immediately after kidney transplantation. However, small depositions of CaOx could be benign while extensive depositions lead to poor graft outcome. Here we report three cases with end-stage renal disease (ESRD), bilateral nephrolithiasis, and unknown diagnosis of primary hyperoxaluria (PH) who underwent a renal transplant and experienced an early-onset graft failure. Although an acute rejection was suspected, renal allograft biopsies and subsequent allograft nephrectomies showed extensive CaOx deposition, which raised a suspicion of PH...
August 2015: Journal of Research in Medical Sciences: the Official Journal of Isfahan University of Medical Sciences
https://www.readbyqxmd.com/read/26586046/transplant-nephrectomy-a-single-center-experience
#19
Arun Ariyarathenam, Alex Bamford, Jacob A Akoh
Transplant nephrectomy (TN) is associated with significant morbidity and mortality and influences the outcome of subsequent renal transplantation. The aim of this study was to identify the reasons for TN in a single transplant center in the United Kingdom and to determine the complication rate, effect on relisting and re-transplantation. We studied all the TNs in our center from January 2000 to December 2011. Detailed information including cause of allograft failure and reason for TN were analyzed. Of 602 renal transplants performed at our center during the period of the study, 42 TNs were performed on 38 (6%) patients (24 men and 14 women)...
November 2015: Saudi Journal of Kidney Diseases and Transplantation
https://www.readbyqxmd.com/read/26529289/sensitization-trends-after-renal-allograft-failure-the-role-of-dq-eplet-mismatches-in-becoming-highly-sensitized
#20
Pooja Singh, Edward J Filippone, Beth W Colombe, Ashesh P Shah, Tingting Zhan, Mary Harach, Chad Gorn, Adam M Frank
Sensitization following renal allograft failure (AF) is highly variable. Some patients remain non-sensitized (NS), while others become highly sensitized (HS). We studied 66 NS patients who experienced AF after initial kidney transplantation. Post-failure, two main groups of NS panel reactive antibody (PRA) class I and II <10% and HS patients (PRA class I or II ≥80%) were identified. The impact of acute rejection (AR), immunosuppression withdrawal (ISW) at AF, allograft nephrectomy, graft intolerance syndrome (GIS), and both standard serologic and eplet-based mismatches (MM) in inducing HS status after failure was examined...
January 2016: Clinical Transplantation
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