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Renal Transplantation

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131 papers 100 to 500 followers
By Isabel Acosta-Ochoa Nephrology senior staff. Valladolid. Spain
Steven Van Laecke, Evi Vanessa Nagler, Patrick Peeters, Francis Verbeke, Wim Van Biesen
Smoking is associated with unfavourable outcome in solid organ transplant recipients. Nicotine may predispose to kidney injury by increasing oxidative stress. We hypothesized that former smoking negatively affects graft outcome in kidney transplant recipients and especially those with delayed graft function (DGF). We included adult recipients of a kidney transplant between January 1(st) 2003 and October 1(st) 2015 at Ghent University Hospital and recorded outcomes until October, 31(st) 2015. We used Kaplan-Meier and multivariable Cox proportional hazard analysis to examine the relationship between former smoking at the time of transplantation and the incidence of 10-year graft loss with and without censoring for death in 1013 participants...
November 28, 2016: Transplant International: Official Journal of the European Society for Organ Transplantation
Johan De Meester
From late nineteen nineties, the higher number of suitable renal transplant candidates has forced the transplant community to re-explore the whole spectrum of deceased donors after brain death (DBD) as well as after cardiac death (DCD); in practice, donors of older age and donors with more chronic diseases or "medical complexities". This new kidney donor population - finally defined as extended criteria donors (ECD) - currently comprises on average 20 to 25%. In his seminal paper in 2003 on the introduction of ECD in the US, Metzger et al...
October 25, 2016: Transplant International: Official Journal of the European Society for Organ Transplantation
Mani Nagarajan, Sakthirajan Ramanathan, Jeyachandran Dhanapriya, Thanigachalam Dineshkumar, T Bala Subramaniyan, Natarajan Gopalakrishnan
BACKGROUND: Acute kidney injury (AKI) is one of the major determinants of graft survival in kidney transplantation (KTx). Renal Transplant recipients are more vulnerable to develop AKI than general population. AKI in the transplant recipient differs from community acquired, in terms of risk factors, etiology and outcome. Our aim was to study the incidence, risk factors, etiology, outcome and the impact of AKI on graft survival. METHODS: A retrospective analysis of 219 renal transplant recipients (both live and deceased donor) was done...
October 24, 2016: Renal Failure
Elias David-Neto, Ana Heloisa Kamada Triboni, Fernanda Ramos, Fabiana Agena, Nelson Zocoler Galante, Marcelo Altona, Francine Brambate Carvalhinho Lemos, Marcelo Tatit Sapienza, William Carlos Nahas
Equations to estimate glomerular filtration rate (eGFR) were developed in patients using the variables age, body weight, and serum creatinine, which may be different in the elderly. Elderly renal transplant patients (EG; n=70; mean age 65 ± 4 y) who measured plasma (51) Cr-EDTA-Clearance (mGFR) had mGFR compared to eGFR obtained by the Cockcroft-Gault corrected by body surface area (CG-BSA), the modification of diet in renal disease (MDRD-4), the Berlin Initiative Study (BIS-1), and the chronic kidney disease epidemiology collaboration (CKD-EPI)...
December 2016: Clinical Transplantation
F J Bemelman, J W de Fijter, J Kers, C Meyer, H Peters-Sengers, E F de Maar, K A M I van der Pant, A P J de Vries, J-S Sanders, A Zwinderman, M M Idu, S Berger, M E J Reinders, C Krikke, I M Bajema, M C van Dijk, I J M Ten Berge, J Ringers, J Lardy, D Roelen, D-J Moes, S Florquin, J J Homan van der Heide
In renal transplantation, use of calcineurin inhibitors (CNIs) is associated with nephrotoxicity and immunosuppression with malignancies and infections. This trial aimed to minimize CNI exposure and total immunosuppression while maintaining efficacy. We performed a randomized controlled, open-label multicenter trial with early cyclosporine A (CsA) elimination. Patients started with basiliximab, prednisolone (P), mycophenolate sodium (MPS), and CsA. At 6 months, immunosuppression was tapered to P/CsA, P/MPS, or P/everolimus (EVL)...
September 17, 2016: American Journal of Transplantation
Evangelos Tsipotis, Navin R Gupta, Gowri Raman, Elias Zintzaras, Bertrand L Jaber
BACKGROUND: Concerns exist over the extrapolation of bioavailability studies of generic immunosuppressive drugs in healthy volunteers, regarding their efficacy and safety in kidney transplant recipients. We conducted a meta-analysis of trials examining the bioavailability of generic (test) immunosuppressive drugs relative to their brand (reference) counterparts in healthy volunteers, based on the US Food and Drug Administration requirements for approval of generics, and their efficacy and safety in kidney transplant recipients...
2016: American Journal of Nephrology
Michele F Eisenga, Isidor Minovic, Stefan P Berger, Jenny E Kootstra-Ros, Else van den Berg, Ineke J Riphagen, Gerjan Navis, Peter van der Meer, Stephan J L Bakker, Carlo A J M Gaillard
Anemia, iron deficiency anemia (IDA) and iron deficiency (ID) are highly prevalent in renal transplant recipients (RTR). Anemia is associated with poor outcome, but the role of ID is unknown. Therefore, we aimed to investigate the association of ID, irrespective of anemia, with all-cause mortality in RTR. Cox regression analyses were used to investigate prospective associations. In 700 RTR, prevalences of anemia, IDA, and ID were 34%, 13%, and 30%, respectively. During follow-up for 3.1 (2.7-3.9) years, 81 (12%) RTR died...
August 12, 2016: Transplant International: Official Journal of the European Society for Organ Transplantation
M Hassanain, E Simoneau, S A Doi, M-J Hebert, P Metrakos, J Tchervenkov
BACKGROUND: The impact of renal function recovery on graft survival was examined using estimated glomerular filtration rate (eGFR) slope after kidney transplantation (GAP classification); this was compared to the conventional classification of immediate graft function (IGF), slow graft function (SGF), and delayed graft function (DGF). MATERIALS AND METHODS: Overall, 541 cases of cadaveric renal transplants were reviewed from a prospective transplant database. eGFR and its slope were measured using the harmonic mean over the first week post-transplantation...
July 2016: Transplantation Proceedings
J Gozdowska, M Czerwińska, Ł Chabros, G Młynarczyk, A Kwiatkowski, A Chmura, M Durlik
INTRODUCTION: The aim of this study was to investigate risk factors for urinary tract infections (UTI), the causative organisms of UTI and also their management and treatment. In addition, we evaluated the effects of UTI on renal graft function. METHODS: This analysis included 107 kidney transplant recipients (64% women) with a diagnosis of UTIs confirmed by positive results on urine culture. Type of pathogens, sensitivity to drugs, risk factors for infection, incidence of urosepsis, hospitalization period, treatment methods, and recurrence rates were analyzed...
June 2016: Transplantation Proceedings
K Majchrzak, E Mierzwinska-Nastalska, A Chmura, A Kwiatkowski, L Paczek, G Mlynarczyk, K Szymanek-Majchrzak
BACKGROUND: Biofilm occurring on removable prostheses is a reservoir of bacterial flora, consisting of both physiological and pathogenic multidrug-resistant microorganisms. Patients undergoing dialysis and organ transplantation are particularly prone to bacterial infections, which can have its source in denture plaque. This study was a comparison of the composition of staphylococcal flora within the surface of the pharyngeal mucous membrane as well as denture plaque in kidney transplant recipients...
June 2016: Transplantation Proceedings
B Zawadzka, S Zawadzka, A Będkowska-Prokop, E Ignacak, W Sułowicz
INTRODUCTION: A patient who complies with doctor recommendations is an indicator of proper cooperation in treatment. It is affected by environmental factors, soft competences of the doctors, and properties of the human personality. We investigated the psychological characteristics of patients that may facilitate human contact and promote healthy behaviors. The aim of the study was to analyze the importance of psychological factors for the occurrence of health-related behaviors necessary for cooperation in treatment...
June 2016: Transplantation Proceedings
Rachel E Patzer, Marina Serper, Peter P Reese, Kamila Przytula, Rachel Koval, Daniela P Ladner, Josh M Levitsky, Michael M Abecassis, Michael S Wolf
We sought to evaluate the prevalence of medication understanding and non-adherence of entire drug regimens among kidney transplantation (KT) recipients and to examine associations of these exposures with clinical outcomes. Structured, in-person interviews were conducted with 99 adult KT recipients between 2011 and 2012 at two transplant centers in Chicago, IL; and Atlanta, GA. Nearly, one-quarter (24%) of participants had limited literacy as measured by the Rapid Estimate of Adult Literacy in Medicine test; patients took a mean of 10 (SD=4) medications and 32% had a medication change within the last month...
October 2016: Clinical Transplantation
Andrea Aguilar
No abstract text is available yet for this article.
July 18, 2016: Nature Reviews. Nephrology
H Liapis, J P Gaut, C Klein, S Bagnasco, E Kraus, A B Farris, E Honsova, A Perkowska-Ptasinska, D David, J Goldberg, M Smith, M Mengel, M Haas, S Seshan, K L Pegas, T Horwedel, Y Paliwa, X Gao, D Landsittel, P Randhawa
The Banff working group on preimplantation biopsy was established to develop consensus criteria (best practice guidelines) for the interpretation of preimplantation kidney biopsies. Digitally scanned slides were used (i) to evaluate interobserver variability of histopathologic findings, comparing frozen sections with formalin-fixed, paraffin-embedded tissue of wedge and needle core biopsies, and (ii) to correlate consensus histopathologic findings with graft outcome in a cohort of biopsies from international medical centers...
June 22, 2016: American Journal of Transplantation
Emily A Blumberg
Urinary tract infections affect between 23 and 75% of renal transplant recipients, an incidence that far exceeds that of the general population.(1) Both asymptomatic bacteriuria and serious infections, including blood stream infections, are common. The impact of these infections on allograft function is controversial; however there has been no definitive linkage of urinary tract infections to long term allograft loss. Despite the absence of evidence, the use of antibiotics to treat individuals with bacteriuria is widespread, even in patients without symptoms...
May 17, 2016: American Journal of Transplantation
Rohit Dewan, Anil K Dasyam, Henke Tan, Alessandro Furlan
Vascular torsion is a rare renal transplant complication which requires prompt diagnosis and surgery to salvage allograft function. We report here a case of renal allograft torsion with interesting imaging findings on unenhanced CT and color Doppler ultrasound. A 60-year-old woman with a history of pancreas and kidney transplant presented to the emergency room with nausea, vomiting, abdominal pain, and minimal urine output. Unenhanced CT of the abdomen demonstrated an enlarged and malrotated renal allograft with moderate hydronephrosis...
2016: Case Reports in Radiology
Philip A Clayton, Wai H Lim, Germaine Wong, Steven J Chadban
Trials designed to assess the effect of interventions on death and graft failure in kidney transplant recipients are not feasible, because these are predominantly late events. Here, we examined the potential of percentage decline in eGFR as a surrogate for hard outcomes. We obtained deidentified data from the Australia and New Zealand Dialysis and Transplant Registry and studied 7949 transplants performed from 1995 to 2009, including 71,845 patient-years of follow-up, 1121 graft losses, and 1192 deaths. We used adjusted Cox proportional hazards models to determine risks of death or death-censored graft failure related to percentage change in eGFR between years 1 and 3 after transplant...
November 2016: Journal of the American Society of Nephrology: JASN
Wai H Lim, Jeremy R Chapman, Patrick T Coates, Joshua R Lewis, Graeme R Russ, Narelle Watson, Rhonda Holdsworth, Germaine Wong
BACKGROUND AND OBJECTIVES: The current allocation algorithm for deceased donor kidney transplantation takes into consideration HLA mismatches at the ABDR loci but not HLA mismatches at other loci, including HLA-DQ. However, the independent effects of incompatibilities for the closely linked HLA-DQ antigens in the context of HLA-DR antigen matched and mismatched allografts are uncertain. We aimed to determine the effect of HLA-DQ mismatches on renal allograft outcomes. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: Using data from the Australia and New Zealand Dialysis and Transplant Registry, we examined the association between HLA-DQ mismatches and acute rejections in primary live and deceased donor kidney transplant recipients between 2004 and 2012 using adjusted Cox regression models...
May 6, 2016: Clinical Journal of the American Society of Nephrology: CJASN
Gerold Thölking, Katharina Schuette-Nuetgen, Dominik Kentrup, Helga Pawelski, Stefan Reuter
Kidney transplantation is the best available treatment for patients with end stage renal disease. Despite the introduction of effective immunosuppressant drugs, episodes of acute allograft rejection still endanger graft survival. Since efficient treatment of acute rejection is available, rapid diagnosis of this reversible graft injury is essential. For diagnosis of rejection, invasive core needle biopsy of the graft is the "gold-standard". However, biopsy carries the risk of significant graft injury and is not immediately feasible in patients taking anticoagulants...
March 24, 2016: World Journal of Transplantation
Zoltán H Endre, Timothy J Pianta, John W Pickering
Post transplant repeated measurements of urine volume and serum creatinine (sCr) are used to assess kidney function. Under non-steady state conditions, repeated measurement of sCr allows calculation of the kinetic estimated GFR (KeGFR). Additional measurement of urinary creatinine allows the calculation of the creatinine excretion to (estimated) production ratio (E/eG). We hypothesized that post-transplant KeGFR and E/eG would predict delayed graft function (DGF), as early as 4 h and outperform a validated clinical model at 12 h...
2016: Nephron
2016-03-09 08:44:15
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