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Living kidney donation

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https://www.readbyqxmd.com/read/28103829/a-comparison-of-the-effects-of-oral-vs-intravenous-hydration-on-subclinical-acute-kidney-injury-in-living-kidney-donors-a-protocol-of-a-randomised-controlled-trial
#1
Shona Mackinnon, Emma Aitken, Ryan Ghita, Marc Clancy
BACKGROUND: Optimal treatment for established renal failure is living donor kidney transplantation. However this pathway exposes healthy individuals to significant reduction in nephron mass via major surgical procedure. Laparoscopic donor nephrectomy is now the most common method for live donor transplantation, reducing both donor post-operative pain and recovery time. However this procedure exposes kidneys to additional haemodynamic stresses. It has been suggested that donor hydration-particularly the use of preoperative intravenous fluids-may counteract these stresses, reducing subclinical acute kidney injury and ultimately improving long-term renal function...
January 19, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/28095803/increased-glomerulonephritis-recurrence-after-living-related-donation
#2
A L Kennard, S H Jiang, G D Walters
BACKGROUND: Kidney transplantation confers superior outcomes for patients with end stage kidney disease, and live donor kidneys associate with superior outcomes compared to deceased donor kidneys. Modern immunosuppression has improved rejection rates and transplant survival and, as a result, recurrence of glomerulonephritis has emerged as a major cause of allograft loss. However, many glomerulonephritides have significant genetic risk which may manifest through kidney intrinsic or systemic mechanisms...
January 17, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/28058212/complement-related-kidney-diseases-recurrence-after-transplantation
#3
REVIEW
Maurizio Salvadori, Elisabetta Bertoni
The recurrence of renal disease after renal transplantation is becoming one of the main causes of graft loss after kidney transplantation. This principally concerns some of the original diseases as the atypical hemolytic uremic syndrome (HUS), the membranoproliferative glomerulonephritis (MPGN), in particular the MPGN now called C3 glomerulopathy. Both this groups of renal diseases are characterized by congenital (genetic) or acquired (auto-antibodies) modifications of the alternative pathway of complement...
December 24, 2016: World Journal of Transplantation
https://www.readbyqxmd.com/read/28049698/effects-of-reduced-kidney-function-because-of-living-kidney-donation-on-left-ventricular-mass
#4
Ursula Altmann, Carsten A Böger, Stefan Farkas, Matthias Mack, Andreas Luchner, Okka W Hamer, Florian Zeman, Kurt Debl, Claudia Fellner, Carsten Jungbauer, Bernhard Banas, Stefan Buchner
Living kidney donation is associated with a small but significant increase in cardiovascular mortality. In addition, mildly decreased kidney function is associated with an increase of left ventricular mass and with cardiovascular disease in patients with chronic kidney disease. To investigate this association, we evaluated the impact of mildly decreased kidney function after living kidney donation on subclinical cardiac structural and functional changes. In this prospective cohort study, cardiac and renal magnetic resonance imaging and laboratory analyses were performed in 23 living kidney donors (mean age 54±10 years, 52% male) before donation and at 4 and 12 months after nephrectomy...
January 3, 2017: Hypertension
https://www.readbyqxmd.com/read/28041626/obesity-increases-the-risk-of-end-stage-renal-disease-among-living-kidney-donors
#5
Jayme E Locke, Rhiannon D Reed, Allan Massie, Paul A MacLennan, Deirdre Sawinski, Vineeta Kumar, Shikha Mehta, Roslyn B Mannon, Robert Gaston, Cora E Lewis, Dorry L Segev
Determining candidacy for live kidney donation among obese individuals remains challenging. Among healthy non-donors, body mass index (BMI) above 30 is associated with a 16% increase in risk of end-stage renal disease (ESRD). However, the impact on the ESRD risk attributable to donation and living with only one kidney remains unknown. Here we studied the risk of ESRD associated with obesity at the time of donation among 119 769 live kidney donors in the United States. Maximum follow-up was 20 years. Obese (BMI above 30) live kidney donors were more likely male, African American, and had higher blood pressure...
December 29, 2016: Kidney International
https://www.readbyqxmd.com/read/28039956/longitudinal-analysis-of-living-donor-kidney-transplant-rates-in-pediatric-candidates-in-the-united-states
#6
Douglas S Keith, Gayle Vranic, John Barcia, Victoria Norwood, Angie Nishio-Lucar
Among adults, living donor kidney transplant rates began declining in the United States after 2004 but whether a similar decline is occurring in the pediatric candidates has not been well studied. Share 35, a change in allocation rules implemented in October of 2005, may also have influenced rates of living donation. We sought to determine whether a decline in rates was occurring in pediatric candidates and whether the Share 35 program was the cause of the decline. All children listed for a kidney transplant or transplanted with a living donor without listing between 1996 and 2011 were identified in the United States (N=14 911) of which 6046 had received a living donor transplant during follow-up...
December 30, 2016: Pediatric Transplantation
https://www.readbyqxmd.com/read/28024112/left-sided-living-kidney-donation-leads-to-transiently-reduced-adrenocortical-responsiveness
#7
F Burn, C Schirpenbach, M Bidlingmaier, M Reincke, D Vetter, D Weishaupt, J G Brockmann, M K Müller, M Weber, F Dahm, A Nocito
Living kidney donation is safe and established, but can lead to long-term complications such as chronic fatigue. Since the adrenal vein is usually transected during left-sided donor nephrectomy - which is not necessary on the right- we hypothesized that venous congestion might lead to an impairment of adrenal function, offering a possible explanation. In this prospective open label, mono-centric cohort study adrenal function was compared in left- and right-sided living kidney donors. The primary endpoint was plasma cortisol response to low-dose ACTH stimulation...
December 26, 2016: American Journal of Transplantation
https://www.readbyqxmd.com/read/28018759/could-the-use-of-an-enhanced-recovery-protocol-in-laparoscopic-donor-nephrectomy-be-an-incentive-for-live-kidney-donation
#8
Aparna Rege, Harold Leraas, Deepak Vikraman, Kadiyala Ravindra, Todd Brennan, Tim Miller, Julie Thacker, Debra Sudan
INTRODUCTION AND BACKGROUND: Gastrointestinal (GI) recovery after major abdominal surgery can be delayed from an ongoing need for narcotic analgesia thereby prolonging hospitalization. Enhanced recovery after surgery (ERAS) is a multimodal perioperative care pathway designed to facilitate early recovery after major surgery by maintaining preoperative body composition and physiological organ function and modifying the stress response induced by surgical exposure. Enhanced recovery programs (ERPs) in colorectal surgery have decreased the duration of postoperative ileus and the hospital stay while showing equivalent morbidity, mortality, and readmission rates in comparison to the traditional standard of care...
November 22, 2016: Curēus
https://www.readbyqxmd.com/read/27998880/social-media-use-among-living-kidney-donors-and-recipients-survey-on-current-practice-and-potential
#9
Abby Swanson Kazley, Bashir Hamidi, Wendy Balliet, Prabhakar Baliga
BACKGROUND: In the United States, there is a national shortage of organs donated for transplant. Among the solid organs, most often kidneys are donated by living donors, but the lack of information and complicated processes limit the number of individuals who serve as living kidney donors. Social media can be a tool for advocacy, educating the public about the need, process, and outcomes of live kidney donors, yet little is known about social media use by kidney transplant patients. OBJECTIVE: The purpose of this study was to examine the social media use of potential kidney transplant patients and their willingness to use social media and their networks to advocate and educate about living kidney donation...
December 20, 2016: Journal of Medical Internet Research
https://www.readbyqxmd.com/read/27997071/integrating-apol-1-gene-variants-into-renal-transplantation-considerations-arising-from-the-american-society-of-transplantation-expert-conference
#10
Kenneth A Newell, Richard Formica, John Gill, Jesse Schold, James S Allan, Shandie Covington, Alexander C Wiseman, Anil Chandraker
Thirteen percent of individuals of African Ancestry express two variant copies of the gene encoding Apolipoprotein 1 (APOL-1) that has been associated with an increased risk of ESRD in the general population. Limited studies suggest that the survival of transplanted kidneys from donors expressing two APOL-1 risk alleles is inferior to that of kidneys from donors with zero or one risk allele. In living kidney donation two case reports describe donors expressing two APOL-1 risk alleles who developed ESRD. Given the potential impact of APOL-1 variants on the utility and safety of kidney transplantation and living kidney donation the AST convened a meeting with the goals of summarizing the current state of knowledge with respect to transplantation and APOL-1, identifying knowledge gaps and studies to address these gaps, and considering approaches to integrating APOL-1 into clinical practice...
December 20, 2016: American Journal of Transplantation
https://www.readbyqxmd.com/read/27994868/outcomes-of-living-kidney-donors-with-medullary-sponge-kidney
#11
Wisit Cheungpasitporn, Charat Thongprayoon, Brady A Brabec, Wonngarm Kittanamongkolchai, Stephen B Erickson
BACKGROUND: Patients with medullary sponge kidney (MSK) commonly encounter recurrent nephrolithiasis. The existing knowledge on safety of donors with MSK has not been studied. METHODS: We conducted a retrospective cohort study at a tertiary referral hospital to assess the outcomes of living kidney donors with MSK. All adults with MSK (N = 26) who underwent nephrectomy as living kidney donors between January 2000 and September 2014 were included. Non-donors with MSK (N = 78) were randomly selected by matching the year of birth and the comorbidity score with a ratio of 1:3 for comparison...
December 2016: Clinical Kidney Journal
https://www.readbyqxmd.com/read/27992110/kidney-exchange-to-overcome-financial-barriers-to-kidney-transplantation
#12
M A Rees, T B Dunn, C S Kuhr, C L Marsh, J Rogers, S E Rees, A Cicero, L J Reece, A E Roth, O Ekwenna, D E Fumo, K D Krawiec, J E Kopke, S Jain, M Tan, S R Paloyo
Organ shortage is the major limitation to kidney transplantation in the developed world. Conversely, millions of patients in the developing world with end-stage renal disease die because they cannot afford renal replacement therapy-even when willing living kidney donors exist. This juxtaposition between countries with funds but no available kidneys and those with available kidneys but no funds prompts us to propose an exchange program using each nation's unique assets. Our proposal leverages the cost savings achieved through earlier transplantation over dialysis to fund the cost of kidney exchange between developed-world patient-donor pairs with immunological barriers and developing-world patient-donor pairs with financial barriers...
November 7, 2016: American Journal of Transplantation
https://www.readbyqxmd.com/read/27959288/living-kidney-donation-and-masked-nationalism-in-israel
#13
Miran Epstein
This paper draws attention to a current trend of masked conditional-nationalist living kidney donation in Israel, to which the local transplant system has been turning a blind eye. The paper seeks to make the international transplant and bioethics communities aware of this disturbing trend. It also explains why it is wrong and suggests how to tackle it. Finally, it calls on the Israeli system to bring the practice to a halt for the benefit of all parties involved.
December 13, 2016: Indian Journal of Medical Ethics
https://www.readbyqxmd.com/read/27942230/iga1-dominant-subclass-of-latent-iga-mesangial-deposition-in-donated-kidney
#14
Kazumasa Oka, Kenji Nishimura, Hidefumi Kishikawa, Yasuji Ichikawa
BACKGROUND: In the pathogenesis of immunoglobulin A nephropathy (IgAN), the IgA1 subclass is more important than the IgA2 subclass. In healthy men, the prevalence of mesangial IgA deposition has been previously investigated. However, it remains unknown whether the presence of urinary abnormalities depends on the subclass of IgA deposition. MATERIALS AND METHODS: We researched the subclasses of IgA (IgA1 and IgA2) by the direct immunofluorescence (IF) staining method using specimens in which we identified the deposition of IgA through zero-hour renal transplant biopsies from donors without urinary abnormalities...
2016: International Journal of Nephrology and Renovascular Disease
https://www.readbyqxmd.com/read/27942168/attitude-of-medical-professionals-regarding-controversial-issues-in-kidney-donation-transplantation
#15
N Almeida, R F Almeida, K Almeida, A Almeida
There is a dire need to evaluate new strategies to bridge the wide kidney demand-supply gap. The current study examined the attitude of medical professionals regarding controversial issues pertaining to transplantation. A questionnaire, presenting controversial issues related to kidney transplantation, in an agree-disagree format with supporting reasons, was employed. The research was exploratory. Data were analyzed quantitatively and qualitatively. The sample comprised 140 doctors from Mumbai (mean = 38.1 years, standard deviation = 17...
November 2016: Indian Journal of Nephrology
https://www.readbyqxmd.com/read/27941440/financial-burden-borne-by-laparoscopic-living-kidney-donors
#16
J Wiseman, C Jacobs, D Larson, D Berglund, C Garvey, H N Ibrahim, A J Matas
INTRODUCTION: Living kidney donors have donation-related, out-of-pocket costs (direct costs) and/or ongoing daily expenses while losing income (indirect costs) associated with donation. Yet there is little information about how much of a subjective burden these constitute for the donors. METHODS: From 12/2003-1/2015, we surveyed donors 6 months postdonation to determine financial burden related to donation (on a scale of 1-10) and what resources were used to cover expenses...
December 8, 2016: Transplantation
https://www.readbyqxmd.com/read/27923612/protocol-of-the-ktft-talk-study-to-reduce-racial-disparities-in-kidney-transplant-evaluation-and-living-donor-kidney-transplantation
#17
Kellee Bornemann, Emilee Croswell, Menna Abaye, Cindy L Bryce, Chung-Chou H Chang, Deborah S Good, Cathleen A Freehling Heiles, Mary Amanda Dew, L Ebony Boulware, Amit D Tevar, Larissa Myaskovsky
Living donor kidney transplantation (LDKT) is the optimal treatment for end-stage kidney disease (ESKD). The evaluation process for a kidney transplant is complex, time consuming, and burdensome to the ESKD patient. Also, race disparities exist in rates of transplant evaluation completion, transplantation, and LDKT. In December 2012 our transplant center implemented a streamlined, one-day evaluation process, dubbed Kidney Transplant Fast Track (KTFT). This paper describes the protocol of a two-part study to evaluate the effectiveness of KTFT at increasing transplant rates (compared to historical controls) and the TALK intervention (Talking About Live Kidney Donation) at increasing LDKT during KTFT...
December 5, 2016: Contemporary Clinical Trials
https://www.readbyqxmd.com/read/27920796/neutrophil-gelatinase-associated-lipocalin-fibroblast-growth-factor-23-and-soluble-klotho-in-long-term-kidney-donors
#18
Inga Strand Thorsen, Inger Hjørdis Bleskestad, Grete Jonsson, Øyvind Skadberg, Lasse Gunnar Gøransson
BACKGROUND: The best treatment for end-stage renal disease (ESRD) is kidney transplantation. Twenty-seven percent of transplantations in Norway are from living donors. Recent studies have shown an increased risk of ESRD and increased mortality in donors. The aim of this study was to determine if the levels of the new biomarkers neutrophil gelatinase-associated lipocalin (NGAL), soluble Klotho (sKlotho), and fibroblast growth factor 23 (FGF23) are changed in kidney donors with normal kidney function defined as an estimated glomerular filtration rate (eGFR) >60 ml/min/1...
September 2016: Nephron Extra
https://www.readbyqxmd.com/read/27908469/-ethics-and-kidney-transplants-with-living-donors
#19
Marie-France Mamzer Bruneel
The ethical debate surrounding transplant practices questions our societies. International recommendations set out numerous precautions which must be taken to ensure that donors act with their free will. While in most countries, including France, organ donation is a voluntary and non-commercial act, a black market exists in the world resulting in the trafficking of organs and tragic transplant tourism.
December 2016: Revue de L'infirmière
https://www.readbyqxmd.com/read/27894119/trajectories-and-predictors-of-allograft-dysfunction-after-renal-transplantation-in-children
#20
Vandréa Carla de Souza, Muriel Rabilloud, Pierre Cochat, Mario Bernardes Wagner, Clotilde Druck Garcia, Bruno Ranchin, Jean Iwaz, Luciano Selistre, Laurence Dubourg
BACKGROUND: The survival rates of renal transplant children are indeed on the rise, but it is still important to ensure that there is optimal renal function in these children in all their future growing years. The number of functioning nephrons and the graft ability to adapt to an increasing demand during body growth seem to be the most important factors for long-term allograft function. This study examined the long-term change in the glomerular filtration rate in a pediatric kidney transplant cohort and the importance of the recipient and donor ages in predicting transplant outcome...
2017: American Journal of Nephrology
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