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Living kidney donation

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https://www.readbyqxmd.com/read/29034143/decision-aids-to-increase-living-donor-kidney-transplantation
#1
Jennifer C Gander, Elisa J Gordon, Rachel E Patzer
PURPOSE OF REVIEW: For the more than 636,000 adults with end-stage renal disease (ESRD) in the U.S., kidney transplantation is the preferred treatment compared to dialysis. Living donor kidney transplantation (LDKT) comprised 31% of kidney transplantations in 2015, an 8% decrease since 2004. We aimed to summarize the current literature on decision aids that could be used to improve LDKT rates. RECENT FINDINGS: Decision aids are evidence-based tools designed to help patients and their families make difficult treatment decisions...
March 2017: Current Transplantation Reports
https://www.readbyqxmd.com/read/29032601/persistent-regional-and-racial-disparities-in-non-directed-living-kidney-donation
#2
Komal Kumar, Courtenay M Holscher, Xun Luo, Jacqueline Garonzik Wang, Saad Anjum, Elizabeth A King, Allan B Massie, James M Tonascia, Tanjala S Purnell, Dorry L Segev
Non-directed living donors (NDLD) are an important and growing source of kidneys to help reduce the organ shortage. In its infancy, NDLD transplantation was clustered at a few transplant centers and rarely benefited African American recipients. However, NDLDs have increased 9.4-fold since 2000, and now are often used to initiate kidney paired donation (KPD) chains. Therefore, we hypothesized that the initial geographic clustering and racial disparities may have improved. We used SRTR data to compare NDLDs and their recipients between 2008-2015 and 2000-2007...
October 15, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/29031488/-outcome-of-living-kidney-donors-for-transplantation
#3
Antoine Lanot, Nicolas Bouvier, Valérie Chatelet, Angélique Lecouf, Xavier Tillou, Bruno Hurault de Ligny
Nowadays, several treatments exist to treat terminal chronic renal failure. Best results for the recipients are obtained with kidney transplantation concerning mortality and quality of life. Transplantation is also the cheaper option for society. Living kidney donation raises the issue of the becoming of the donor, an absolutely healthy subject who gets to a surgical procedure. The becoming of living kidney donors has been compared with the one of controls subjects in several studies. The evaluations focused on the complications of nephrectomy in the short and long-term: kidney failure, hypertension, proteinuria, possibility of pregnancy, quality of life, and mortality...
October 11, 2017: Néphrologie & Thérapeutique
https://www.readbyqxmd.com/read/29027035/no-significant-differences-in-short-term-renal-prognosis-between-living-kidney-donors-with-and-without-diabetes
#4
Takahiro Shinzato, Akira Kurosawa, Taro Kubo, Toshihiro Shimizu, Takaaki Kimura, Koji Nanmoku, Takashi Yagisawa
BACKGROUND: Renal prognosis in living kidney donors with diabetes is currently not known. In this study, we sought to investigate renal prognosis in living kidney donors with diabetes. METHODS: We retrospectively investigated 241 living kidney donors who underwent nephrectomy at Jichi Medical University Hospital between January 2000 and December 2015. Donors with a follow-up period of less than 1 year were excluded. The remaining donors were divided into a diabetic group and a non-diabetic group...
October 12, 2017: Clinical and Experimental Nephrology
https://www.readbyqxmd.com/read/29024864/association-between-serum-uric-acid-level-and-renal-arteriolar-hyalinization-in-individuals-without-chronic-kidney-disease
#5
Yuta Matsukuma, Kosuke Masutani, Shigeru Tanaka, Akihiro Tsuchimoto, Naoki Haruyama, Yasuhiro Okabe, Masafumi Nakamura, Kazuhiko Tsuruya, Takanari Kitazono
BACKGROUND AND AIMS: Recent studies have reported an association between serum uric acid (SUA) and renal arteriolar changes in patients with chronic kidney disease (CKD). However, the association in individuals without CKD remains unclear. In this study, we investigated the relationship between SUA and renal arteriolar lesions in individuals without CKD from our living kidney donor cohort. METHODS: Between January 2006 and May 2016, 393 living kidney donors underwent "time-zero" biopsy at Kyushu University Hospital...
September 19, 2017: Atherosclerosis
https://www.readbyqxmd.com/read/29020932/difficult-conversations-australian-indigenous-patients-views-on-kidney-transplantation
#6
Jeannie Devitt, Kate Anderson, Joan Cunningham, Cilla Preece, Paul Snelling, Alan Cass
BACKGROUND: Indigenous Australians suffer a disproportionate burden of end stage kidney disease (ESKD) but are significantly less likely to receive a transplant. This study explores Indigenous ESKD patients' views on transplantation as a treatment option. METHODS: The Improving Access to Kidney Transplants (IMPAKT) research program investigated barriers to kidney transplantation for Indigenous Australians. An interview study, conducted in 2005-2006, elicited illness experience narratives from 146 Indigenous patients, including views on transplant...
October 11, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/28993303/the-lived-experience-of-being-evaluated-for-organ-donation-focus-groups-with-living-kidney-donors
#7
Camilla S Hanson, Angelique F Ralph, Karine E Manera, John S Gill, John Kanellis, Germaine Wong, Jonathan C Craig, Jeremy R Chapman, Allison Tong
BACKGROUND AND OBJECTIVES: Comprehensive evaluations are required to safeguard voluntarism and minimize harm to living kidney donors. This process is lengthy, invasive, and emotionally challenging, with up to one fifth of potential donors opting out. We aimed to describe donors' experiences of the evaluation process. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: We conducted 14 focus groups involving 123 kidney donors who completed donation from three transplant centers (Australia and Canada)...
October 9, 2017: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/28992338/the-association-of-donor-and-recipient-age-with-graft-survival-in-paediatric-renal-transplant-recipients-in-a-european-society-for-paediatric-nephrology-european-renal-association-european-dialysis-and-transplantation-association-registry-study
#8
Nicholas C Chesnaye, Karlijn J van Stralen, Marjolein Bonthuis, Jaap W Groothoff, Jérôme Harambat, Franz Schaefer, Nur Canpolat, Arnaud Garnier, James Heaf, Huib de Jong, Søren Schwartz Sørensen, Burkhard Tönshoff, Kitty J Jager
Background: The impact of donor age in paediatric kidney transplantation is unclear. We therefore examined the association of donor-recipient age combinations with graft survival in children. Methods: Data for 4686 first kidney transplantations performed in 13 countries in 1990-2013 were extracted from the ESPN/ERA-EDTA Registry. The effect of donor and recipient age combinations on 5-year graft-failure risk, stratified by donor source, was estimated using Kaplan-Meier survival curves and Cox regression, while adjusting for sex, primary renal diseases with a high risk of recurrence, pre-emptive transplantation, year of transplantation and country...
September 15, 2017: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/28980397/gfr-%C3%A2-25-years-postdonation-in-donors-with-vs-without-a-1-st-degree-relative-with-esrd
#9
Arthur J Matas, David M Vock, Hassan N Ibrahim
An increased risk of ESRD has been reported for living kidney donors, and appears to be higher for those donating to a relative. The reasons for this are not clear. One possibility is that ESRD may be due the nephrectomy-related reduction in GFR, followed by an age-related decline that may be more rapid in related donors. Between 1/1/1990 - 12/31/2014, we did 2002 living donor nephrectomies. We compared long-term postdonation eGFR trajectory for donors with (n=1245) versus without (n=757) a first-degree relative with ESRD...
October 5, 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/28979784/seventy-seven-kidney-paired-donation-transplantations-at-a-single-transplant-centre-in-india-led-to-an-increase-in-living-donor-kidney-transplantations-in-2015
#10
Vivek B Kute, Himanshu V Patel, Pankaj R Shah, Pranjal R Modi, Veena R Shah, Sayyed J Rizvi, Bipin C Pal, Priya S Shah, Umesh T Varyani, Pavan S Wakhare, Saiprasad G Shinde, Vijay A Ghodela, Varsha B Trivedi, Minaxi H Patel, Hargovind L Trivedi
BACKGROUND: To ascertain the validity of kidney paired donations (KPDs) as an alternative strategy for increasing living donor kidney transplantations (LDKTs) in an LDKT-dominated transplant programme since directed kidney transplantation, ABO-incompatible or crossmatch-positive pairs are not feasible due to costs and infectious complications. METHODS: This was a prospective single-centre study of 77 KPD transplantations (25 two-way, 7 three-way and 1 six-way exchange) from 1 January 2015 to 1 January 2016 of 158 registered donor recipient pairs...
October 2017: Clinical Kidney Journal
https://www.readbyqxmd.com/read/28978532/tubular-maximum-phosphate-reabsorption-capacity-in-living-kidney-donors-is-independently-associated-with-one-year-recipient-gfr
#11
Marco van Londen, Brigitte M Aarts, Jan-Stephan F Sanders, Jan-Luuk Hillebrands, Stephan J L Bakker, Gerjan Navis, Martin H de Borst
The donor glomerular filtration rate (GFR) measured before kidney donation is a strong determinant of recipient graft outcome. No tubular function markers have been identified that can similarly be used in donors to predict recipient outcomes. In the current study we investigated whether the predonation tubular maximum reabsorption capacity of phosphate (TmP-GFR), which may be considered as a functional tubular marker in healthy kidney donors, is associated with recipient GFR at one year after transplantation, a key determinant of long-term outcome...
October 4, 2017: American Journal of Physiology. Renal Physiology
https://www.readbyqxmd.com/read/28975705/potential-yield-of-imminent-death-kidney-donation
#12
Ryan A Denu, Eneida A Mendonca, Norman Fost
About 99,000 people are waiting for a kidney in the US, and many will die waiting. The concept of "imminent death" donation, a type of living donation, has been gaining attention among physicians, patients, and ethicists. We estimated the number of potential imminent death kidney donors at the University of Wisconsin Hospital and Clinics by estimating the number of annual deaths in individuals with normal kidney function. Based on a previous survey suggesting that 1/3 of patients might be willing to donate at imminent death, we estimate that between 76 and 396 people in the state of Wisconsin would be medically eligible and willing to donate each year at the time of imminent death...
October 4, 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/28963768/reassessing-risks-and-benefits-of-living-kidney-donors-with-a-history-of-thyroid-cancer
#13
Joel T Adler, Heidi Yeh, Giuseppe Barbesino, Carrie C Lubitz
Many potential and willing living kidney donors are excluded from donating for a history of malignancy. There is appropriate caution toward patients with a history of malignancy because of concern for transmission of donor-derived malignancy. Thyroid cancer is common and increasing in incidence, and outcomes are very good in otherwise young, healthy potential donors. We review the evidence and guidelines regarding recurrence and transmission risk of thyroid cancer, and then we suggest a standardized guideline for otherwise healthy donors with a history of thyroid malignancy...
September 29, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/28944160/strategies-for-assessing-gfr-and-albuminuria-in-the-living-kidney-donor-evaluation
#14
Lesley A Inker, Naya Huang, Andrew S Levey
PURPOSE OF REVIEW: The international guideline development group Kidney Disease Improving Global Outcomes (KDIGO) recently published a comprehensive set of recommendations for living donor evaluation which contains a new framework for decision making in the evaluation of kidney donor candidates. RECENT FINDINGS: The guidelines recommend that decisions to accept or decline a candidate donor should be based on incorporation of multiple sources of information pertaining to the donor candidate's likelihood of serious adverse outcomes after donation...
March 2017: Current Transplantation Reports
https://www.readbyqxmd.com/read/28939572/understanding-barriers-and-outcomes-of-unspecified-non-directed-altruistic-kidney-donation-from-both-professional-s-and-patient-s-perspectives-research-protocol-for-a-national-multicentre-mixed-methods-prospective-cohort-study
#15
Rebecca Gare, Petrut Gogalniceanu, Hannah Maple, Lisa Burnapp, Alexis Clarke, Lynsey Williams, Sam Norton, Joseph Chilcot, Paul Gibbs, Annie Mitchell, Paul McCrone, Heather Draper, Nizam Mamode
INTRODUCTION: Living donation accounts for over one-third of all kidney transplants taking place in the UK. (1) The concept of anonymously donating a kidney to a stranger (non-directed altruistic or unspecified kidney donation (UKD)) remains uncomfortable for some clinicians, principally due to concerns about the motivations and long-term physical and psychological outcomes in this donor group. AIMS: The research programme aims to provide a comprehensive assessment of the unspecified donor programme in the UK...
September 21, 2017: BMJ Open
https://www.readbyqxmd.com/read/28937061/long-term-evaluation-of-kidney-function-in-live-related-kidney-donors
#16
Kalpana S Mehta, Rudramani Swami, Atim Pajai, Sandip Bhurke, Abhishek Shirkande, Sunil Jawle
The consequences of live kidney donation on the donor health with main emphasis on postdonation blood pressure (BP), proteinuria, kidney size, and glomerular filtration rate (GFR) were evaluated. Twenty-five donors with minimum of six months postdonation duration were included in the study. Donor age at nephrectomy, duration postnephrectomy, systolic and diastolic BP measurement pre-and post-donation, postdonation, blood urea nitrogen, serum creatinine and 24-h proteinuria, blood sugar, two-dimensional echocardiogram were recorded...
September 2017: Saudi Journal of Kidney Diseases and Transplantation
https://www.readbyqxmd.com/read/28923617/postdonation-anemia-in-living-kidney-donors
#17
S Shah, B Lankowsky, T Gao, Z Zaky, B R Stephany, E D Poggio
BACKGROUND: The effect of nephrectomy on development of anemia in living kidney donation has not been well studied. We hypothesized that the remaining kidney volume and function after donation are determinants of hemoglobin (Hb) concentration and postdonation anemia (PDA). METHODS: We studied 398 living kidney donors (LKDs) who donated from January 2001 to December 2013. Demographic variables, hematologic variables, renal mass, and renal function were investigated as factors associated with PDA with the use of univariate and multivariable logistical regression analysis...
October 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28922907/organ-vouchers-and-barter-markets-saving-lives-reducing-suffering-and-trading-in-human-organs
#18
Mark J Cherry
The essays in this issue of The Journal of Medicine and Philosophy explore an innovative voucher program for encouraging kidney donation. Discussions cluster around a number of central moral and political/theoretical themes: (1) What are the direct and indirect health care costs and benefits of such a voucher system in human organs? (2) Do vouchers lead to more effective and efficient organ procurement and allocation or contribute to greater inequalities and inefficiencies in the transplantation system? (3) Do vouchers contribute to the inappropriate commodification of human body parts? (4) Is there a significant moral difference between such a voucher system and a market in human organs for transplantation? This paper argues that while kidney vouchers constitute a step in the right direction, fuller utilization of market-based incentives, including, but not limited to, barter exchanges (e...
October 1, 2017: Journal of Medicine and Philosophy
https://www.readbyqxmd.com/read/28922903/banking-on-living-kidney-donors-a-new-way-to-facilitate-donation-without-compromising-on-ethical-values
#19
Dominique E Martin, Gabriel M Danovitch
Public surveys conducted in many countries report widespread willingness of individuals to donate a kidney while alive to a family member or close friend, yet thousands suffer and many die each year while waiting for a kidney transplant. Advocates of financial incentive programs or "regulated markets" in kidneys present the problem of the kidney shortage as one of insufficient public motivation to donate, arguing that incentives will increase the number of donors. Others believe the solutions lie-at least in part-in facilitating so-called "altruistic donation;" harnessing the willingness of relatives and friends to donate by addressing the many barriers which serve as disincentives to living donation...
October 1, 2017: Journal of Medicine and Philosophy
https://www.readbyqxmd.com/read/28889098/reversal-of-arterial-stiffness-and-maladaptative-arterial-remodeling-after-kidney-transplantation
#20
Alexandre Karras, Pierre Boutouyrie, Marie Briet, Erwan Bozec, Jean-Philippe Haymann, Christophe Legendre, Lawrence P McMahon, Michel Delahousse
BACKGROUND: Chronic kidney disease is characterized by stiffening, thinning, dilatation, and increased circumferential wall stress of large arteries, associated with increased cardiovascular risk. Kidney transplantation (KT) reverses many pathological features of chronic kidney disease and improves life expectancy; however, longitudinal studies exploring the impact of KT on recipient large arteries are scarce. METHODS AND RESULTS: This study was designed to appraise arterial changes following KT...
September 9, 2017: Journal of the American Heart Association
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