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https://www.readbyqxmd.com/read/29782661/comparable-outcomes-in-intestinal-retransplantation-single-center-cohort-study
#1
Burcin Ekser, Chandrashekhar A Kubal, Jonathan A Fridell, Richard S Mangus
BACKGROUND: Graft loss in intestinal transplantation (ITx) is close to 25% in the first year and 50% at 5-year post-transplantation. Although technically and immunologically challenging, intestinal retransplantation is now the 4th most common indication for ITx. METHODS: The aim of this study is to review and compare the outcomes of intestinal retransplantation with primary ITx, which included isolated ITx, modified multivisceral transplantation (mMVTx), and full MVTx, between 2003-2014 at Indiana University...
May 21, 2018: Clinical Transplantation
https://www.readbyqxmd.com/read/29778671/international-study-of-comparative-health-effectiveness-with-medical-and-invasive-approaches-ischemia-trial-rationale-and-design
#2
David J Maron, Judith S Hochman, Sean M O'Brien, Harmony R Reynolds, William E Boden, Gregg W Stone, Sripal Bangalore, John A Spertus, Daniel B Mark, Karen P Alexander, Leslee Shaw, Jeffrey S Berger, T Bruce Ferguson, David O Williams, Robert A Harrington, Yves Rosenberg
BACKGROUND: Prior trials comparing a strategy of optimal medical therapy with or without revascularization have not shown that revascularization reduces cardiovascular events in patients with stable ischemic heart disease (SIHD). However, those trials only included participants in whom coronary anatomy was known prior to randomization and did not include sufficient numbers of participants with significant ischemia. It remains unknown whether a routine invasive approach offers incremental value over a conservative approach with catheterization reserved for failure of medical therapy in patients with moderate or severe ischemia...
April 21, 2018: American Heart Journal
https://www.readbyqxmd.com/read/29770967/developmental-programming-of-renal-function-nephron-endowment-and-beyond
#3
Andrew G Woodman, Stephane L Bourque
In the face of adversity, the fetal kidney doesn't fare well. When resources are limiting due to pregnancy complications such as placental insufficiency, maternal hypoxia, or nutrient deficiencies, kidney development is often compromised, showing signs of reduced growth, defective nephrogenesis, and abnormal morphology. This article is protected by copyright. All rights reserved.
May 17, 2018: Journal of Physiology
https://www.readbyqxmd.com/read/29767455/ureterocalicostomy-with-lower-pole-nephrectomy-in-a-renal-transplant-a-case-report
#4
Rafael Haddad Astolfi, Guilherme Alonso Daud Patavino, Claudia Felipe Rosso, Helio Tedesco Silva Junior, Jose Osmar Medina Pestana, Alex Elton Meller, Wilson Aguiar
As the number of kidney transplants continues to rise, so does the number and complexities of surgical-related complications, which may be associated with increased morbidity and potentially graft loss. Ureteral stenosis, the most prevalent urological complication, may require diverse techniques for surgical correction depending on several recipient and graft abnormalities. Here we report the surgical and clinical outcomes of a 62-year-old man with a postransplant pyeloureterostomy stricture successfully treated with ureterocalycostomy after a lower pole nephrectomy...
May 16, 2018: American Journal of Transplantation
https://www.readbyqxmd.com/read/29754418/comprehensive-outcomes-after-lung-retransplantation-a-single-center-review
#5
Kieran Halloran, Meghan Aversa, Kathryn Tinckam, Tereza Martinu, Matthew Binnie, Cecilia Chaparro, Chung-Wai Chow, Tom Waddell, Karen McRae, Andrew Pierre, Marc de Perrot, Kazuhiro Yasufuku, Marcelo Cypel, Shaf Keshavjee, Lianne G Singer
INTRODUCTION: Lung retransplantation is an important therapy for a growing population of lung transplant recipients with graft failure, but detailed outcome data are lacking. METHODS: We conducted a retrospective cohort study of adult lung retransplant in the Toronto Lung Transplant Program from 2001 to 2013 (n=38). We analyzed the post-operative course, graft function, renal function, microbiology, donor specific antibodies (DSA), quality of life and survival compared to a control cohort of primary transplant recipients matched for age and era...
May 13, 2018: Clinical Transplantation
https://www.readbyqxmd.com/read/29750392/laparoscopic-versus-robot-assisted-partial-nephrectomy-for-renal-tumors-larger-than-4-cm-a-propensity-score-based-analysis
#6
Liangyou Gu, Hongzhao Li, Baojun Wang, Yongpeng Xie, Xintao Li, Yu Gao, Xiangjun Lyu, Qingbo Huang, Yang Fan, Yuanxin Yao, Yunpeng Wang, Xin Ma, Xu Zhang
OBJECTIVES: To compare perioperative, functional, and oncological outcomes between laparoscopic partial nephrectomy (LPN) and robot-assisted partial nephrectomy (RAPN) for renal tumors >4 cm. MATERIAL AND METHODS: We retrospectively reviewed patients who underwent either LPN or RAPN between 2008 and 2015. To adjust for potential baseline confounders, propensity-score matching (1:1) was performed. Perioperative data, and functional and oncological outcomes were reviewed...
May 11, 2018: BJU International
https://www.readbyqxmd.com/read/29740877/eversion-endarterectomy-of-the-deceased-donor-renal-artery-to-prevent-kidney-discard
#7
Muhammad A Khan, Hany El-Hennawy, Korie C Jones, David Harriman, Alan C Farney, Jeffrey Rogers, Giuseppe Orlando, Robert J Stratta
INTRODUCTION: Deceased donor (DD) kidneys exhibiting severe atherosclerosis involving the renal artery (RA) may represent a contraindication to kidney transplantation (KT). METHODS: Eversion endarterectomy (EE) was performed as a salvage procedure to permit KT. RESULTS: We identified 17 cases (1.2% of all DD KTs during the study period) involving EE of the DD RA. Thirteen (76.5%) kidneys were imported and mean Kidney Donor Profile Index (KDPI) was 81%...
May 8, 2018: Clinical Transplantation
https://www.readbyqxmd.com/read/29733461/topical-application-of-quercetin-improves-wound-healing-in-pressure-ulcer-lesions
#8
Guimei Yin, Zhijing Wang, Zhaoxia Wang, Xirui Wang
The ischemia-reperfusion (I/R) induced skin lesion has been identified as primary cause of pressure ulcers. To date, attempts to prevent pressure ulcers have not produced a significant improvement. Quercetin, one of the most widely distributed flavonoids in fruits and vegetables, exhibits its antioxidant and anti-inflammatory properties against many diseases, including ischemic heart disease, atherosclerosis, and renal injury. In vitro wound scratch assay was first used to assess the function of quercetin in wounding cell model...
May 7, 2018: Experimental Dermatology
https://www.readbyqxmd.com/read/29730878/silver-absorption-and-toxicity-evaluation-of-silver-wound-dressings-in-40-patients-with-chronic-wounds
#9
C Brouillard, A-C Bursztejn, C Latarche, J-F Cuny, F Truchetet, J-P Goullé, J-L Schmutz
BACKGROUND: Silver-containing dressings are considered to be safe even though there have been some reports of complications, including argyria and various organ system dysfunctions. Despite the widespread use of silver dressings, little research has been done regarding the absorption and toxicity of silver. OBJECTIVE: We aimed to study the systemic absorption of silver in patients with chronic inflammatory wounds and to determine associated factors of systemic silver absorption and evaluated its association with silver toxicity...
May 6, 2018: Journal of the European Academy of Dermatology and Venereology: JEADV
https://www.readbyqxmd.com/read/29722128/five-year-outcomes-in-kidney-transplant-patients-randomized-to-everolimus-with-cyclosporine-withdrawal-or-low-exposure-cyclosporine-versus-standard-therapy
#10
Claudia Sommerer, Michael Duerr, Oliver Witzke, Frank Lehner, Wolfgang Arns, Volker Kliem, Daniel Ackermann, Markus Guba, Johannes Jacobi, Ingeborg A Hauser, Rolf Stahl, Petra Reinke, Thomas Rath, Justyna Veit, Arianeb Mehrabi, Martina Porstner, Klemens Budde
HERAKLES was a one-year randomized, multicenter trial. Patients were randomized at three months after kidney transplantation to remain on cyclosporine-based therapy, switch to everolimus without a calcineurin inhibitor (CNI), or switch to everolimus with low-exposure cyclosporine. Overall, 417/497 (83.9%) patients from the core study entered a four-year extension study. The randomized regimen was continued to year 5 in 75.9%, 41.9% and 24.6% of patients in the standard-CNI, CNI-free and low-CNI groups, respectively...
May 2, 2018: American Journal of Transplantation
https://www.readbyqxmd.com/read/29722011/end-stage-renal-disease-dialysis-kidney-transplantation-and-their-impact-on-cd4-t-cell-differentiation
#11
Matthias Schaier, Angele Leick, Lorenz Uhlmann, Florian Kälble, Christian Morath, Volker Eckstein, Anthony Ho, Carsten Mueller-Tidow, Stefan Meuer, Karsten Mahnke, Claudia Sommerer, Martin Zeier, Andrea Steinborn
Premature aging of both CD4+ -regulatory- (Tregs) and CD4+ -responder-T-cells (Tresps) in end-stage renal disease (ESRD) patients is expected to affect the success of later kidney transplantation. Both T-cell populations are released from the thymus as inducible co-stimulatory (ICOS+ -) and ICOS- -recent thymic emigrant (RTE)-Tregs/Tresps, which differ primarily in their proliferative capacities. In this study, we analysed the effect of ESRD and subsequent renal replacement therapies on the differentiation of ICOS+ - and ICOS- -RTE-Tregs/Tresps into ICOS+ - or ICOS- -CD31- -Memory-Tregs/Tresps and examined whether diverging pathways affected the suppressive activity of ICOS+ - and ICOS- -Tregs in co-culture with autologous Tresps...
May 2, 2018: Immunology
https://www.readbyqxmd.com/read/29718537/resolution-of-hbv-infection-occurs-sooner-than-recovery-of-renal-disease-in-adult-serum-hbsag-negative-hbv-associated-glomerulonephritis
#12
Fang Xu, Chong Wang, Xiaoju Shi, Jie Hou, Xiaolin Guo, Pujun Gao
BACKGROUND: Most cases of hepatitis B virus-associated glomerulonephritis (HBV-GN) occur in children and present with serum HBsAg positivity. Few studies have investigated adult HBV-GN patients who are serum HBsAg-negative. This study aimed to determine the clinical and pathological features of serum HBsAg-negative adult HBV-GN patients. METHODS: Clinical, pathologic and laboratory findings were collected and analyzed in a cohort of 27 adult HBV-GN patients who were serum HBsAg negative upon diagnosis...
May 2, 2018: Journal of Medical Virology
https://www.readbyqxmd.com/read/29716799/emergency-and-critical-care-applications-for-contrast-enhanced-ultrasound
#13
REVIEW
Tobias Kummer, Laura Oh, Mary Beth Phelan, Robert D Huang, Jason T Nomura, Srikar Adhikari
INTRODUCTION: Contrast-enhanced ultrasound (CEUS) using intravascular microbubbles has potential to revolutionize point-of-care ultrasonography by expanding the use of ultrasonography into clinical scenarios previously reserved for computed tomography (CT), magnetic resonance imaging, or angiography. METHODS: We performed a literature search and report clinical experience to provide an introduction to CEUS and describe its current applications for point-of-care indications...
April 22, 2018: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29714040/mitoprotection-preserves-the-renal-vasculature-in-porcine-metabolic-syndrome
#14
Alfonso Eirin, Ahmad F Hedayat, Christopher M Ferguson, Stephen C Textor, Amir Lerman, Lilach O Lerman
NEW FINDINGS: What is the central question of this study? We hypothesized that chronic mitoprotection would decrease renal vascular remodeling and dysfunction in swine metabolic syndrome. What is the main finding and its importance? This study shows that experimental metabolic syndrome exerts renal microvascular and endothelial cell mitochondrial injury, which were attenuated by mitoprotection, underscoring the contribution of mitochondrial injury to the pathogenesis of metabolic syndrome-induced vascular damage...
April 30, 2018: Experimental Physiology
https://www.readbyqxmd.com/read/29714030/calciphylaxis-in-end-stage-liver-and-renal-disease-patients-before-and-after-transplant
#15
REVIEW
Thomas Couri, Matthew Stier, Adam Mikolajczyk, Andrew Aronsohn
Calciphylaxis is a rare vascular disorder characterized by calcification of arterioles which causes tissue inflammation and necrosis. It is associated with the metabolic disturbances seen in end stage renal disease (ESRD) and has also been described in patients with cirrhosis with preserved kidney function. Characteristic calciphylaxis lesions are black eschars surrounded by retiform purpura, and the gold standard for diagnosis is skin biopsy. Reported one-year mortality rates range between 45-80%. No treatment modality has been evaluated in a prospective randomized trial, and reports of treatment efficacy vary...
April 30, 2018: Clinical Transplantation
https://www.readbyqxmd.com/read/29698588/-normal-creatinine-levels-predict-persistent-kidney-injury-and-waitlist-mortality-in-outpatients-with-cirrhosis
#16
Giuseppe Cullaro, Meyeon Park, Jennifer C Lai
Acute kidney injury (AKI) is a critical determinant of outcomes in hospitalized patients with cirrhosis, but little is known of the impact of AKI in the outpatient setting. We analyzed 385 adult outpatients with cirrhosis listed for liver transplant at a single center; excluded were those with severe hepatic encephalopathy, hepatocellular carcinoma or on hemodialysis. Baseline serum creatinine (bCr) was defined as the lowest value recorded; peak creatinine (pCr) as the highest value; delta creatinine (ΔCr) as pCr minus bCr; AKI as a rise in sCR by ≥0...
April 26, 2018: Hepatology: Official Journal of the American Association for the Study of Liver Diseases
https://www.readbyqxmd.com/read/29687651/tlr9-deficiency-breaks-tolerance-to-rna-associated-antigens-and-upregulates-tlr7-protein-in-sle1-mice
#17
Teja Celhar, Hiroko Yasuga, Hui-Yin Lee, Olga Zharkova, Shubhita Tripathi, Susannah I Thornhill, Hao K Lu, Bijin Au, Lina H K Lim, Thomas P Thamboo, Shizuo Akira, Edward K Wakeland, John E Connolly, Anna-Marie Fairhurst
OBJECTIVE: Toll-like receptors (TLRs) 7 and 9 are important innate signaling molecules with opposing roles in the development and progression of Systemic Lupus Erythematosus (SLE). While multiple studies support a dependency on TLR7 for disease development, genetic ablation of TLR9 results in severe disease with glomerulonephritis (GN) by a largely unknown mechanism. The present study was designed to examine the suppressive role of TLR9 in the development of severe lupus. METHODS: We crossed Sle1 lupus-prone mice with TLR9-deficient mice to generate Sle1TLR9-/- ...
April 24, 2018: Arthritis & Rheumatology
https://www.readbyqxmd.com/read/29682860/the-role-of-chronic-kidney-disease-and-atrial-fibrillation-on-outcomes-of-ischaemic-stroke-patients
#18
Ahsan A Khan, Gregory Y H Lip
Stroke is one of the leading causes of morbidity and mortality in the western world. Approximately 85% of strokes are ischaemic, caused by vascular occlusion either due to acute thrombus or emboli often as a result of atrial fibrillation (AF). Other age dependent conditions such as hypertension and diabetes mellitus lead to impairment of renal function and development of chronic kidney disease (CKD). Indeed, CKD is increasingly prevalent in the elderly population and is an independent predictor of stroke recurrence, mortality and poor clinical outcomes after acute ischaemic stroke (1)...
April 23, 2018: European Journal of Neurology: the Official Journal of the European Federation of Neurological Societies
https://www.readbyqxmd.com/read/29681697/estimation-of-renal-functional-reserve-in-children-with-different-grades-of-vesicoureteric-reflux
#19
Rafey Abdul Rahman, Veereshwar Bhatnagar, Sandeep Agarwala, Rakesh Kumar
Background: Vesicoureteric reflux (VUR) is one of the most common anomalies encountered in pediatric urology. The concept of renal functional reserve (RFR) as the ability of the kidney to increase glomerular filtration rate (GFR) following a protein load was introduced in the 1980s. Aim: This study aims to evaluate RFR using 99 Tc diethylenetriamine pentaacetic acid (DTPA) as the filtration agent for GFR estimation in children with VUR. Materials and Methods: RFR was estimated in 53 children, of which 31 patients had unilateral VUR (Group I) and 22 patients had bilateral VUR (Group II), by subtracting baseline GFR from stimulated GFR following an intravenous protein load...
April 2018: Journal of Indian Association of Pediatric Surgeons
https://www.readbyqxmd.com/read/29679515/the-influence-of-mtor-inhibitors-on-the-incidence-of-cmv-infection-in-high-risk-donor-positive-recipient-negative-d-r-kidney-transplant-recipients
#20
M P Cristelli, R M Esmeraldo, C Motta Pinto, T V Sandes-Freitas, C Felipe, C F Lobo, L Viana, J Mansur, S Stopa, D W C Santos, P C Grenzi, W F Aguiar, H Tedesco-Silva, J O Medina-Pestana
Several studies and meta-analysis suggest the mTOR inhibitors are associated with reduced incidence of CMV infection after kidney transplantation, although their effects on the high-risk population have not been investigated thoroughly. This retrospective cohort study investigates the association between immunosuppression and CMV infection in D+/R- kidney transplant recipients receiving preemptive therapy. All patients received rabbit anti-thymocyte globulin, tacrolimus, prednisone and azathioprine (AZA), mycophenolate (MPA) or everolimus (EVR)...
April 21, 2018: Transplant Infectious Disease: An Official Journal of the Transplantation Society
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