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Renal Transplantation

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262 papers 100 to 500 followers
By Isabel Acosta-Ochoa Nephrology senior staff. Valladolid. Spain
https://www.readbyqxmd.com/read/29768153/improving-the-supply-and-quality-of-deceased-donor-organs-for-transplantation
#1
Stefan G Tullius, Hamid Rabb
New England Journal of Medicine, Volume 378, Issue 20, Page 1920-1929, May 2018.
May 17, 2018: New England Journal of Medicine
https://www.readbyqxmd.com/read/29776389/what-is-the-impact-of-human-leukocyte-antigen-mismatching-on-graft-survival-and-mortality-in-renal-transplantation-a-meta-analysis-of-23-cohort-studies-involving-486-608-recipients
#2
Xinmiao Shi, Jicheng Lv, Wenke Han, Xuhui Zhong, Xinfang Xie, Baige Su, Jie Ding
BACKGROUND: The magnitude effects of human leukocyte antigen (HLA) mismatching on post-transplant outcomes of kidney transplantation remain controversial. We aim to quantitatively assess the associations of HLA mismatching with graft survival and mortality in adult kidney transplantation. METHODS: We searched PubMed, EMBASE and the Cochrane Library from their inception to December, 2016. Priori clinical outcomes were overall graft failure, death-censored graft failure and all-cause mortality...
May 18, 2018: BMC Nephrology
https://www.readbyqxmd.com/read/29762458/association-between-duration-of-delayed-graft-function-acute-rejection-and-allograft-outcome-after-deceased-donor-kidney-transplantation
#3
Wai H Lim, David W Johnson, Armando Teixeira-Pinto, Germaine Wong
BACKGROUND: Prolonged duration of delayed graft function (DGF) may be associated with adverse allograft outcomes, but the association between threshold duration of DGF, acute rejection and long-term allograft loss remains undefined. We aimed to determine the impact of DGF duration on allograft outcomes and to assess whether this association was mediated by acute rejection. METHODS: Using data from the Australian and New Zealand Dialysis and Transplant (ANZDATA) registry, Cox proportional modelling was used to determine the association between quartiles of DGF duration, acute rejection at 6 months and death-censored graft loss (DCGL)...
May 14, 2018: Transplantation
https://www.readbyqxmd.com/read/29753404/cardiovascular-disease-after-kidney-transplant
#4
REVIEW
Nitesh N Rao, P Toby Coates
Renal transplantation is the preferred treatment for patients with end-stage kidney disease. However, despite successful kidney transplantation, cardiovascular disease (CVD) remains one of the major causes of patient death and hence graft loss. The antecedents of this increased risk reside within the development of end-stage kidney disease and dialysis. Risk factors for the development of CVD include diabetes, hypertension, and dyslipidemia. Other transplant-specific factors include the presence of a patent arteriovenous fistula and immunosuppressive therapy...
May 2018: Seminars in Nephrology
https://www.readbyqxmd.com/read/29740877/eversion-endarterectomy-of-the-deceased-donor-renal-artery-to-prevent-kidney-discard
#5
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/29735310/factors-leading-to-the-discard-of-deceased-donor-kidneys-in-the-united-states
#6
Sumit Mohan, Mariana C Chiles, Rachel E Patzer, Stephen O Pastan, S Ali Husain, Dustin J Carpenter, Geoffrey K Dube, R John Crew, Lloyd E Ratner, David J Cohen
The proportion of deceased donor kidneys procured for transplant but subsequently discarded has been growing steadily in the United States, but factors contributing to the rising discard rate remain unclear. To assess the reasons for and probability of organ discard we assembled a cohort of 212,305 deceased donor kidneys recovered for transplant from 2000-2015 in the SRTR registry that included 36,700 kidneys that were discarded. 'Biopsy Findings' (38.2%) was the most commonly reported reason for discard. The median Kidney Donor Risk Index of discarded kidneys was significantly higher than transplanted organs (1...
May 5, 2018: Kidney International
https://www.readbyqxmd.com/read/29734154/treatment-of-posttransplantation-anemia
#7
Kohei Unagami, Masayoshi Okumi, Tomomi Tamura, Hideki Ishida, Kazunari Tanabe, Kosaku Nitta
Kidney transplantation represents a renal replacement therapy for end-stage renal failure, with outcomes improving from year to year. With the improved survival prognosis, treatment of complications of chronic kidney disease after transplantation is becoming increasingly important. In particular, posttransplantation anemia (PTA) is often protracted, which could be related to a variety of factors, including the renal function status, graft rejection episodes, and infectious causes. PTA occurs in about 30-40% of transplant recipients, and is known to affect the function of the transplanted kidney as well as patient survival...
2018: Contributions to Nephrology
https://www.readbyqxmd.com/read/29734498/measuring-and-monitoring-equity-in-access-to-deceased-donor-kidney-transplantation
#8
D E Stewart, A R Wilk, A E Toll, A M Harper, R R Lehman, A M Robinson, S A Noreen, E B Edwards, D K Klassen
The OPTN monitors progress toward strategic goals such as increasing the number of transplants and improving waitlisted patient, living donor, and transplant recipient outcomes. However, a methodology for assessing system performance in providing equity in access to transplants was lacking. We present a novel approach for quantifying the degree of disparity in access to deceased donor kidney transplants among waitlisted patients and determine which factors are most associated with disparities. A Poisson rate regression model was built for each of 29 quarterly, period-prevalent cohorts (1/1/10-3/31/17; 5 years pre-KAS, 2 years post-KAS) of active kidney waiting list registrations...
May 7, 2018: American Journal of Transplantation
https://www.readbyqxmd.com/read/29722081/liver-alone-or-simultaneous-liver-kidney-transplant-pre-transplant-chronic-kidney-disease-and-post-transplant-outcome-a-retrospective-study
#9
Shunji Nagai, Mohamed Safwan, Kelly Collins, Randolph E Schilke, Michael Rizzari, Dilip Moonka, Kimberly Brown, Anita Patel, Atsushi Yoshida, Marwan Abouljoud
The new Organ Procurement and Transplant Network/United Organ Sharing Network (OPTN/UNOS) simultaneous liver-kidney transplant (SLK) policy has been implemented. The aim of this study was to review liver transplant outcomes utilizing the new SLK policy. Liver transplant alone (LTA) and SLK patients between 2009 and 2015 were reviewed. Graft survival and post-transplant kidney function were investigated among LTA patients meeting the chronic kidney disease (CKD) criteria of the new policy (LTA-CKD group). In order to validate our findings, we reviewed and applied our analysis to the OPTN/UNOS registry...
May 2, 2018: Transplant International: Official Journal of the European Society for Organ Transplantation
https://www.readbyqxmd.com/read/29706414/-current-insights-about-recurrence-of-glomerular-diseases-after-renal-transplantation
#10
Tomek Kofman, Julie Oniszczuk, Philippe Lang, Philippe Grimbert, Vincent Audard
Recurrence of glomerular disease after renal transplantation is a frequent cause of graft loss. Incidence, risk factors and outcome of recurrence are widely due to the underlying glomerular disease. Graft biopsy analysis is required to confirm the definitive diagnosis of recurrence and to start an appropriate therapy that, in some cases, remains challenging to prevent graft failure. Increased use of protocol biopsy and recent advances in our understanding of the pathogenesis of some glomerular diseases with the identification of some relevant biomarkers provide a unique opportunity to initiate kidney-protective therapy at early stages of recurrence on the graft...
April 26, 2018: Néphrologie & Thérapeutique
https://www.readbyqxmd.com/read/29700591/the-role-of-mr-imaging-in-the-assessment-of-renal-allograft-vasculature
#11
REVIEW
Raj Gondalia, Federica Vernuccio, Daniele Marin, Mustafa R Bashir
Renal allograft dysfunction after transplantation is a relatively common occurrence with various potential etiologies. Vascular etiologies are of particular importance as early surgical or minimally invasive intervention can, in some cases, salvage the graft. Diagnosis of vascular pathology resulting in allograft dysfunction requires a thorough workup, of which imaging is a key component. Generally, ultrasound is the first-line imaging modality. More recently, MRI has been shown to be an effective and safe modality for diagnosis of vascular pathology after renal transplantation, particularly for diagnosis of transplant renal artery stenosis...
April 26, 2018: Abdominal Radiology
https://www.readbyqxmd.com/read/29701380/renal-autotransplantation-the-solution-for-different-pathologies
#12
Pedro Pinto Sousa, Rui Machado, Pedro Sá Pinto, Rui Almeida
INTRODUCTION: Renal autotransplantation (RA) is a safe and effective procedure to reconstruct the urinary tract which first successful surgery was performed by Hardy in 1963. The main indications reported for performing RA generally includes renovascular disease, ureteral pathologies and neoplastic disease. RA may be also useful as the last recourse in preventing kidney loss in highly selected patients, especially when conventional methods have failed. METHODS: The authors pretend to describe four total different situations where the RA was the key solution for the pathology initially presented...
July 2017: Revista Portuguesa de Cirurgia Cardio-torácica e Vascular
https://www.readbyqxmd.com/read/29687948/hepatitis-c-virus-infected-kidney-wait-list-patients-treat-now-or-treat-later
#13
B A Kiberd, K Doucette, A J Vinson, K K Tennankore
Currently many but not all centers transplant HCV viremic positive (+) donor kidneys into HCV+ recipients. Directed donation of HCV+ organs reduces the wait time to transplantation for HCV+ patients. Direct acting antiviral (DAA) therapy has the ability to cure HCV in virtually all infected. Some have suggested that treatment of HCV+ wait listed patients be deferred with the hope that earlier transplantation will provide better outcomes than early DAA therapy. However there are not enough organs to guarantee prompt transplantation for the current wait list of infected candidates...
April 24, 2018: American Journal of Transplantation
https://www.readbyqxmd.com/read/29688995/correlation-between-kidney-transplant-outcome-metrics-and-waitlist-metrics
#14
Sheng Zhou, Courtenay M Holscher, Allan B Massie, Dorry L Segev, Lauren Hersch Nicholas
No abstract text is available yet for this article.
April 23, 2018: Transplantation
https://www.readbyqxmd.com/read/29685925/hla-dq-mismatching-and-kidney-transplant-outcomes
#15
Napat Leeaphorn, Jeremy Ryan A Pena, Natanong Thamcharoen, Eliyahu V Khankin, Martha Pavlakis, Francesca Cardarelli
BACKGROUND AND OBJECTIVES: Recent evidence suggests that HLA epitope-mismatching at HLA-DQ loci is associated with the development of anti-DQ donor-specific antibodies and adverse graft outcomes. However, the clinical significance of broad antigen HLA-DQ mismatching for graft outcomes is not well examined. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: Using the United Network Organ Sharing/the Organ Procurement and Transplantation Network (UNOS/OPTN) data, patients with primary kidney transplants performed between 2005 and 2014 were included...
April 23, 2018: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/29677074/frailty-inflammatory-markers-and-waitlist-mortality-among-patients-with-end-stage-renal-disease-in-a-prospective-cohort-study
#16
Mara A McAdams-DeMarco, Hao Ying, Alvin G Thomas, Fatima Warsame, Ashton A Shaffer, Christine E Haugen, Jacqueline M Garonzik-Wang, Niraj M Desai, Ravi Varadhan, Jeremy Walston, Silas P Norman, Dorry L Segev
BACKGROUND: Among community-dwelling older adults, frailty is associated with heightened markers of inflammation and subsequent mortality. Although frailty is common among ESRD patients, the role of frailty and markers of inflammation in this population remains unclear. We quantified these associations in patients on the kidney transplant (KT) waitlist and tested whether frailty and/or markers of inflammation improve waitlist mortality risk prediction. METHODS: We studied 1,975 ESRD patients on the KT waitlist (11/1/09-2/28/17) in a multi-center cohort study of frailty...
April 19, 2018: Transplantation
https://www.readbyqxmd.com/read/29676018/conversion-from-tacrolimus-mycophenolate-mofetil-to-tacrolimus-mtor-immunosuppression-after-kidney-pancreas-transplantation-reduces-the-incidence-of-both-bk-and-cmv-viremia
#17
Richard J Knight, Edward A Graviss, Duc T Nguyen, Samantha A Kuten, Samir J Patel, Lillian Gaber, A Osama Gaber
BACKGROUND: We sought to determine if conversion from tacrolimus/mycophenolate mofetil (TAC-MMF) to tacrolimus/mTOR inhibitor (TAC-mTOR) immunosuppression would reduce the incidences of BK and CMV viremia after kidney/pancreas (KP) transplantation. METHODS: In this single center review, the TAC-mTOR cohort (n=39) was converted at one month post-transplant to an mTOR inhibitor and reduced dose tacrolimus. Outcomes were compared to a cohort of KP recipients (n=40) maintained on TAC-MMF...
April 19, 2018: Clinical Transplantation
https://www.readbyqxmd.com/read/29659397/scintigraphic-and-sonographic-findings-of-subcapsular-cortical-necrosis-in-a-transplanted-kidney
#18
Bulent Yazici, Emrah Gunay, Aysegül Akgün, Sait Sen, Suha Sureyya Ozbek
Renal transplant scintigraphy, performed in a 23-year-old man who had renal graft from a living donor, showed nearly normal perfusion and moderately low function of the graft. But the margins of the graft were blurred, and it was interestingly appearing enlarged late in the study. Ultrasound demonstrated a hypoechoic rim surrounding the whole kidney. Biopsy revealed necrosis besides normal cortical tissue. Necrosis was thought to be limited to the subcapsular cortical area. It should be considered that these scintigraphic findings could be due to greatly reduced and delayed perfusion of edematous subcapsular necrotic area of the graft even in normal perfusion images...
April 13, 2018: Clinical Nuclear Medicine
https://www.readbyqxmd.com/read/29628415/review-management-of-patients-with-kidney-allograft-failure
#19
REVIEW
Kim L W Bunthof, Marc Hazzan, Luuk B Hilbrands
Late allograft loss in kidney transplant recipients remains a common problem and is associated with high mortality and morbidity. The management of patients with a failed kidney allograft includes a few major dilemmas: when to start dialysis, what is the optimal management regarding immunosuppression, and should an allograft nephrectomy be performed. In suitable candidates for a repeated transplantation there are additional matters to take in consideration. In this review we will discuss these dilemmas by providing an overview of current evidence and gaps in our knowledge...
March 29, 2018: Transplantation Reviews
https://www.readbyqxmd.com/read/29656398/impact-of-prolonged-dialysis-prior-to-renal-transplantation
#20
David D Aufhauser, Allison W Peng, Douglas R Murken, Seth J Concors, Peter L Abt, Deirdre Sawinski, Roy D Bloom, Peter P Reese, Matthew H Levine
INTRODUCTION: The new Kidney Allocation System (KAS) prioritizes patients based on date of dialysis initiation or wait-listing, whichever is earlier. We hypothesized that this change would increase transplant rates for patients with prolonged pre-transplant dialysis times (DT) and aimed to assess the impact of prolonged DT on post-transplant outcomes. METHODS: We used United Network for Organ Sharing registry data to assess outcomes for patients added to the renal transplant waitlist from Jan 1 1998 - Dec 31 2010 and patients transplanted from Jan 1 1998 - Dec 3 2012...
April 15, 2018: Clinical Transplantation
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