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Renal Transplantation

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331 papers 100 to 500 followers
By Isabel Acosta-Ochoa Nephrology senior staff. Valladolid. Spain
Paul A Devine, Aisling E Courtney, Alexander P Maxwell
Successful kidney transplantation offers patients with end-stage renal disease the greatest likelihood of survival. However, cardiovascular disease poses a major threat to both graft and patient survival in this cohort. Transplant recipients are unique in their accumulation of a wide range of traditional and non-traditional cardiovascular risk factors. Hypertension, diabetes, dyslipidaemia and obesity are highly prevalent in patients with end-stage renal disease. These risk factors persist following transplantation and are often exacerbated by the drugs used for immunosuppression in organ transplantation...
November 7, 2018: Journal of Nephrology
Yi-Tao Zheng, Chen-Bao Chen, Xiao-Peng Yuan, Chang-Xi Wang
The acute kidney injury (AKI) of deceased donors was an important strategy to address donor shortage. This meta-analysis was conducted to explore the clinical effect of kidney transplantation from donors with AKI. PubMed, Embase, and Cochrane Library were searched through July 2017. Fourteen cohort studies, involving a total of 15,345 donors, were included. Studies were pooled, and the hazard ratio (HR), relative risk (RR), weighted mean difference (WMD), and their corresponding 95% confidence interval (CI) were calculated...
November 2018: Renal Failure
Iratxe López-Pelayo, María Auxiliadora Mazuecos Blanca, María Victoria García Palacios, Fátima Galán Sánchez, Francisca López Rodríguez, María Angeles Bailén García
OBJECTIVES: Management of renal transplant recipients involves measuring glomerular filtration rate and albuminuria; however, data are conflicting on the use of estimating equations or creatinine clearance and albumin-creatinine ratio in early morning urine or albumin excretion in 24-hour urine. We aimed to determine the performance of creatinine clearance and 3 estimated creatinine-based formulas and compare the usefulness of albumin-creatinine ratio related to albumin excretion in kidney transplant patients...
October 24, 2018: Experimental and Clinical Transplantation
Hani M Wadei, Surakit Pungpapong, Cherise Cortese, Mariam P Alexander, Andrew P Keaveny, Liu Yang, C Burcin Taner, Kristopher P Croome
Treating chronic hepatitis C (HCV) using direct acting antiviral agents (DAA) results in high cure rates in immunocompetent hosts with manageable side effects, opening the door to transplanting organs from donors infected with HCV into HCV naïve recipients. Several studies using HCV nucleic acid testing (NAT) positive donors into HCV naïve recipients demonstrated almost complete post-transplant HCV eradication. However, these were industry supported clinical trials with no limitations in access to DAA therapy...
October 29, 2018: American Journal of Transplantation
Dustin Carpenter, S Ali Husain, Corey Brennan, Ibrahim Batal, Isaac E Hall, Dominick Santoriello, Raphael Rosen, R John Crew, Eric Campenot, Geoffrey K Dube, Jai Radhakrishnan, M Barry Stokes, P Rodrigo Sandoval, Vivette D'Agati, David J Cohen, Lloyd E Ratner, Glen Markowitz, Sumit Mohan
BACKGROUND AND OBJECTIVES: Biopsies taken at deceased donor kidney procurement continue to be cited as a leading reason for discard; however, the reproducibility and prognostic capability of these biopsies are controversial. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: We compiled a retrospective, single-institution, continuous cohort of deceased donor kidney transplants performed from 2006 to 2009. Procurement biopsy information-percentage of glomerulosclerosis, interstitial fibrosis/tubular atrophy, and vascular disease-was obtained from the national transplant database...
October 25, 2018: Clinical Journal of the American Society of Nephrology: CJASN
Alan G Jardine, Anders Hartmann, Hallvard Holdaas
Short-term renal allograft survival has improved more quickly than long-term outcomes. Analysis of more than 100,000 deceased donor renal transplants in Europe from 1986 to 2015 identified a declining rate of improvement in 1-year, death-censored graft survival but a continued improvement in longer-term survival, with a year-on-year 3% reduction in the risk of graft failure. These reassuring observations likely reflect improved overall transplant management rather than specific advances.
November 2018: Kidney International
Matthew Cooper, Richard Formica, John Friedewald, Ryutaro Hirose, Kevin O'Connor, Sumit Mohan, Jesse Schold, David Axelrod, Stephen Pastan
The organ shortage is one of the major challenges in the field of organ transplantation, yet the percentage of kidneys procured and discarded prior to transplantation has continued to rise to twenty percent. The causes of organ discard are complex, yet an urgent need exists for collaborative efforts to maximize the utilization of all potentially transplantable renal allografts. The National Kidney Foundation convened a meeting of experts to identify factors contributing to reduced organ utilization, and to propose actionable solutions to decrease the rate of kidney discards...
October 21, 2018: Clinical Transplantation
Ahmed Abbas, Yusuf A Rajabally
Intravenous immunoglobulin (IVIg) forms a cornerstone of effective treatment for acute and chronic inflammatory neuropathies, with a class I evidence base in Guillain-Barré syndrome (GBS), chronic inflammatory demyelinating polyneuropathy (CIDP) and multifocal motor neuropathy (MMN). It is generally considered to be a safe therapy however there are several recognised complications which are reviewed in this article. Most adverse events are immediate and mild such as headache, fever and nausea although more serious immediate reactions such as anaphylaxis may rarely occur...
October 17, 2018: Current Drug Safety
Vaishnavi Pochineni, Helbert Rondon-Berrios
Kidney transplantation is the current treatment of choice for patients with end-stage renal disease. Innovations in transplantation and immunosuppression regimens have greatly improved the renal allograft survival. Based on recently published data from the Scientific Registry of Transplant recipients, prevalence of kidney transplants is steadily rising in the United States. Over 210,000 kidney transplant recipients were alive with a functioning graft in mid-2016, which is nearly twice as many as in 2005. While successful renal transplantation corrects most of the electrolyte and mineral abnormalities seen in advanced renal failure, the abnormalities seen in the post-transplant period are surprisingly different from those seen in chronic kidney disease...
2018: Frontiers in Medicine
Camilla S Hanson, Benedicte Sautenet, Jonathan C Craig, Jeremy R Chapman, Greg Knoll, Peter P Reese, Allison Tong
BACKGROUND: Evidence about outcomes following living kidney donation is needed both to inform donor acceptance criteria, and to guide the decisions of potential donors and their healthcare providers about donation. However, the scope and heterogeneity of outcomes reported in research and their relevance to decision-making is uncertain. To determine the spectrum and consistency of outcomes reported in randomized trials and observational studies in living kidney donors aged 18 years or over...
October 25, 2018: Transplantation
M Han, N Y Jeong, S Y Oh, C I Choi, Y S Chung, H W Lee, H Rhee, E Y Seong, S H Song
Kidney transplant recipients are at increased risk of cardiovascular morbidity and malignant neoplasm, and meticulous evaluation of potential recipients is needed to minimize risks of complications after transplantation. The purpose of this study was to analyze the results of preoperative assessments and document the importance of timed and detailed examinations. METHODS: Medical records of patients evaluated as kidney transplant candidates from January 2015 to September 2017 were retrospectively collected and analyzed...
October 2018: Transplantation Proceedings
J G Gwon, M-G Kim, K T Park, S-Y Ko, C W Jung
INTRODUCTION: Kidneys from acute kidney injury (AKI) donors are used for kidney transplantation. However, different Acute Kidney Injury Network (AKIN) criteria may show varying results after transplantation. We investigated the clinical outcomes in kidney transplantation from deceased donors with AKI as defined by the AKIN criteria at a single center. METHODS: We retrospectively reviewed the medical records of 101 consecutive deceased donors and kidney transplantation recipients from March 2009 to June 2015 in a single center...
October 2018: Transplantation Proceedings
Sara Querido, André Weigert, Teresa Adragão, Luís Rodrigues, Cristina Jorge, Margarida Bruges, Domingos Machado
BACKGROUND: Previous contact with Hepatitis B virus (HBV) is common in patients undergoing hemodialysis. Literature has shown conflicting results on the risk of HBV reactivation in kidney transplant (KT) recipients with serologic evidence of past HBV infection. METHODS: We reviewed 631 consecutive KT recipients and selected 70 patients simultaneously HBsAg-negative and anti-HBc-positive before KT, regardless of hepatitis B surface antibody (anti-HBs) status. Demographic characteristics, co-infection with other viruses, presence of a previous KT, induction and maintenance immunosuppression, length of follow up, biopsy-proven acute rejection episodes, incidence of impaired liver function and causes of graft loss and mortality were collected...
October 8, 2018: Transplant Infectious Disease: An Official Journal of the Transplantation Society
Andy K H Lim, Arushi Kansal, John Kanellis
BACKGROUND: Anaemia after kidney transplantation may reduce quality of life, graft or patient survival. We aimed to determine the prevalence and risk factors for anaemia in the initial 12 months after transplantation. METHODS: We conducted a cross-sectional study at 6 and 12 months after transplantation. Anaemia was defined by World Health Organization criteria taking into consideration erythropoietin use. Logistic regression was used to determine the association between demographic, clinical and pharmacological risk factors for the main outcome of moderate-severe anaemia...
October 5, 2018: BMC Nephrology
Lisa Ghyselen, Maarten Naesens
In this review, we describe the indications, surgical aspects, benefits and risks of nephrectomy after graft failure. There is a great variation in the number of allograft nephrectomies performed among different centers. Nephrectomy of a failed allograft is associated with significant morbidity and mortality with a complication rate of 20-30% and mortality rates between 0% and 11%. A systematic review through Medline (Pubmed) and Embase identified thirteen retrospective studies that compared patients with and patients without allograft nephrectomy prior to retransplantation...
September 6, 2018: Transplantation Reviews
Isaac E Hall, Chirag R Parikh, Bernd Schröppel, Francis L Weng, Yaqi Jia, Heather Thiessen-Philbrook, Peter P Reese, Mona D Doshi
Background: Efforts to maximize transplantation by matching organ quality to recipient longevity require reliable tools. The US kidney allocation system uses the Kidney Donor Risk Index (KDRI) for this purpose, and many centers additionally rely on donor biopsies. The Leuven score combines donor age with procurement histology (glomerulosclerosis and interstitial fibrosis/tubular atrophy) to predict allograft survival. Methods: We compared KDRI with Leuven scores for associations with kidney discard, delayed graft function, and allograft function and survival...
August 2018: Transplantation Direct
Omar Alkandari, Lieuko Nguyen, Diane Hebert, Valerie Langlois, Natasha A Jawa, Rulan S Parekh, Lisa A Robinson
BACKGROUND AND OBJECTIVES: AKI is associated with progression of CKD. Little is known about AKI after kidney transplantation in pediatric recipients. We aim to describe the epidemiology, risk factors, consequences, and outcomes of AKI in this population. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: We performed a retrospective longitudinal analysis of pediatric kidney transplant recipients followed at The Hospital for Sick Children (Toronto, Canada) from 2001 to 2012...
September 21, 2018: Clinical Journal of the American Society of Nephrology: CJASN
Wen-Hsin Tseng, Yu-Feng Tian, Alex Chien-Hwa Liao, Ming-Jenn Chen, Hsuan-Ying Ho, Jinn-Rung Kuo, Steven K Huang
BACKGROUND: Kidney transplantation is the preferred renal replacement therapy for patients with end-stage renal disease, but the waiting list for kidneys continues to grow because of a shortage of donor organs. The reuse of transplanted kidneys would seem to be a good approach to expand the pool of available organs. Here, we describe the reuse of a kidney 9 years after the initial transplantation. At 4-year follow-up, the second recipient is showing good renal function. CASE PRESENTATION: In 2005, a kidney was transplanted from a 40-year-old man, who suffered brain death due to an intracranial hemorrhage, into a 45-year-old man...
September 17, 2018: BMC Nephrology
Meg L McFetridge, Mark P Del Borgo, Marie-Isabel Aguilar, Sharon D Ricardo
Chronic kidney disease (CKD) is a major and growing public health concern with increasing incidence and prevalence worldwide. The therapeutic potential of stem cell therapy, including mesenchymal stem cells (MSCs) and endothelial progenitor cells (EPCs) holds great promise for treatment of CKD. However, there are significant bottlenecks in the clinical translation due to the reduced number of transplanted cells and the duration of their presence at the site of tissue damage. Bioengineered hydrogels may provide a route of cell delivery to enhance treatment efficacy and optimise the targeting effectiveness while minimising any loss of cell function...
September 14, 2018: Clinical Science (1979-)
Xingxing S Cheng, Stephan Busque, Jenny Lee, Kevin Discipulo, Christine Hartley, Zeynep Tulu, John D Scandling, Jane C Tan
Kidney transplant wait-list management is becoming increasingly complex. We introduced a novel wait-list management strategy at our center, the Transplant Readiness Assessment Clinic (TRAC), whereby patients whose Kidney Allocation Scores surpass a threshold are actively managed. From January 1, 2016 through June 30, 2017, we evaluated 195 patients through TRAC. Compared to pre-TRAC systems at our institution, TRAC resulted in a higher proportion of activation at 18 months (38% vs 22%-26%, P < 0.0001), despite being enriched in patients with long dialysis duration...
September 15, 2018: Clinical Transplantation
2018-09-18 11:27:32
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