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Renal Transplantation

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237 papers 100 to 500 followers
By Isabel Acosta-Ochoa Nephrology senior staff. Valladolid. Spain
Yelena Slinin, Michelle Brasure, Keith Eidman, Jason Bydash, Saugar Maripuri, Maureen Carlyle, Areef Ishani, Timothy J Wilt
BACKGROUND: In an effort to improve outcomes associated with living kidney donation, the Kidney Diseases Improving Global Outcomes (KDIGO) assembled a Work Group to develop comprehensive guidelines addressing the evaluation and care of living kidney donors. We conducted this systematic review to inform guideline development. METHODS: We searched Ovid Medline, Ovid Embase, and the Cochrane Library to identify systematic reviews, randomized controlled trials, and observational studies published through September of 2014 and consulted the KDIGO Expert Work Group...
June 2016: Transplantation
Sergio A Acuna, Rinku Sutradhar, S Joseph Kim, Nancy N Baxter
BACKGROUND: Solid organ transplant recipients (SOTR) with pretransplant malignancies (PTM) have worse overall survival (OS) compared to recipients without history of malignancy. However, it is unknown whether the increased risk of mortality is due to recurrent cancer-related deaths. METHODS: All SOTR in Ontario between 1991 and 2010 were identified and matched 1:2 to recipients without PTM using a propensity score. OS was compared using the Kaplan-Meier estimator and Cox proportional hazard models...
March 20, 2018: Transplantation
Kendra E Brett, Lindsay J Ritchie, Emily Ertel, Alexandria Bennett, Greg A Knoll
BACKGROUND: The best approach for determining whether a transplant program is delivering high-quality care is unknown. This review aims to identify and characterize quality metrics in solid organ transplantation. METHODS: Medline, Embase, and Cochrane Central Register of Controlled Trials were searched from inception until February 1 2017. Relevant full text reports and conference abstracts that examined quality metrics in organ transplantation were included. Two reviewers independently extracted study characteristics and quality metrics from 52 full text reports and 24 abstracts...
March 20, 2018: Transplantation
Tomas Lorant, Mats Bengtsson, Torsten Eich, Britt-Marie Eriksson, Lena Winstedt, Sofia Järnum, Yvonne Stenberg, Anna-Karin Robertson, Kristina Mosén, Lars Björck, Lars Bäckman, Erik Larsson, Kathryn Wood, Gunnar Tufveson, Christian Kjellman
Safety, immunogenicity, pharmacokinetics and efficacy of the immunoglobulin G-degrading enzyme of Streptococcus pyogenes (IdeS, Imlifidase) was assessed in a single centre, open label ascending dose study in highly sensitised chronic kidney disease patients. Eight patients with cytotoxic panel-reactive antibodies (median cytotoxic PRA of 64%) at enrolment received 1 or 2 intravenous infusions of IdeS on consecutive days (0.12 mg/kg body weight x2 (n=3); 0.25 mg/kg x1 (n=3) or 0.25 mg/kg x2 (n=2)). IgG degradation was observed in all subjects after IdeS treatment, with <1% plasma IgG remaining within 48 hours and remaining low up to 7 days...
March 21, 2018: American Journal of Transplantation
Tianyi Xia, Sang Zhu, Yan Wen, Shouhong Gao, Mingming Li, Xia Tao, Feng Zhang, Wansheng Chen
Background: Nephrotoxicity of calcineurin inhibitors (CNIs) is the major concern for long-term allograft survival despite its predominant role in current immunosuppressive regime after renal transplantation. CNI nephrotoxicity is multifactorial with demographic, environmental, and pharmacogenetic flexibility, whereas studies indicating risk factors for CNI nephrotoxicity obtained incomplete or conflicting results. Methods: A systematic review and meta-analysis of risk factors for CNI nephrotoxicity was performed on all retrieved studies through a comprehensive research of network database...
2018: Drug Design, Development and Therapy
Meng Yu, Mouze Liu, Wei Zhang, Yingzi Ming
Tacrolimus(Tac) is a first-line immunosuppressive drug used mainly after allogeneic organ transplant to reduce rejection. Tac is proved to be effective in preventing acute rejection, yet it has considerable toxicity and displays marked inter-individual variability in its pharmacokinetics(PK) and pharmacodynamics(PD). Established pharmacogenetics(PG) discoveries are being investigated on drug absorption, metabolism, disposition, excretion and response for better clinical application. The purpose of the present review is to picture the current status of Tac PG, and discuss the relationship between its PK and PD in kidney transplantation...
January 29, 2018: Current Drug Metabolism
Christine M Durand, Mary G Bowring, Diane M Brown, Michael A Chattergoon, Guido Massaccesi, Nichole Bair, Russell Wesson, Ashraf Reyad, Fizza F Naqvi, Darin Ostrander, Jeremy Sugarman, Dorry L Segev, Mark Sulkowski, Niraj M Desai
Background: Given the high mortality rate for patients with end-stage kidney disease receiving dialysis and the efficacy and safety of hepatitis C virus (HCV) treatments, discarded kidneys from HCV-infected donors may be a neglected public health resource. Objective: To determine the tolerability and feasibility of using direct-acting antivirals (DAAs) as prophylaxis before and after kidney transplantation from HCV-infected donors to non-HCV-infected recipients (that is, HCV D+/R- transplantation)...
March 6, 2018: Annals of Internal Medicine
L E J Peeters, L M Andrews, D A Hesselink, B C M de Winter, T van Gelder
The number of elderly people has increased considerably over the last decades, due to a rising life expectancy and ageing populations. As a result, an increased number of elderly with end-stage-renal-disease are diagnosed, for which the preferred treatment is renal transplantation. Over the past years the awareness of the elderly as a specific patient population has grown, which increases the importance of research in this group. Elderly patients often receive kidneys from elderly donors while younger donor kidneys are preferentially reserved for younger recipients...
February 28, 2018: Pharmacological Research: the Official Journal of the Italian Pharmacological Society
J Reinier F Narvaez, Jing Nie, Katia Noyes, Mary Leeman, Liise K Kayler
Understanding risk factors for deceased-donor kidney non-transplantation is important since discard rates remain high. We analyzed DonorNet® data of consecutive deceased-donor non-mandatory share primary kidney-only offers to adult candidates at our center and beyond between July 1, 2015 and March 31, 2016 for donor- and system-level risk factors of discard, defined as non-transplantation at our or subsequent transplant centers. Exclusions were HCV/HBV, blood type AB, and donor< 1 year based on low candidate waitlist size...
March 2, 2018: American Journal of Transplantation
Nicholas B Cross, Ian Dittmer
No abstract text is available yet for this article.
February 26, 2018: Transplantation
Frédéric Lapostolle, Virginie Siguret, Anne-Céline Martin, Claire Pailleret, Bernard Vigué, Yves Zerbib, Karim Tazarourte
The recent emergence of 'non-VKA' oral anticoagulants may have led to some forgetting that vitamin K antagonists (VKA) are by far the most widely prescribed oral anticoagulants worldwide. Consequently, we decided to summarize the information available on them. This paper presents the problems facing emergency physicians confronted with patients on VKAs in 10 points, from pharmacological data to emergency management. Vitamin K antagonists remain preferable in many situations including in the elderly, in patients with extreme body weights, severe chronic kidney or liver disease or valvular heart disease, and in patients taking VKAs with well-controlled international normalized ratios (INRs)...
February 16, 2018: European Journal of Emergency Medicine: Official Journal of the European Society for Emergency Medicine
Neetika Garg, Helmut G Rennke, Martha Pavlakis, Kambiz Zandi-Nejad
Thrombotic microangiopathy (TMA) is a serious complication of transplantation that adversely affects kidney transplant recipient and allograft survival. Post-transplant TMA is usually classified into two categories: 1) recurrent TMA and 2) de novo TMA. Atypical hemolytic uremic syndrome (aHUS) resulting from dysregulation and over-activation of the alternate complement pathway is a rare disease but the most common diagnosis associated with recurrence in the allografts. De novo TMA, on the other hand, represents an overwhelming majority of the cases of post-transplant TMA and is a substantially more heterogeneous entity than recurrent aHUS...
January 2018: Transplantation Reviews
Mary Carmelle Philogene, Sheng Zhou, Bonnie E Lonze, Serena Bagnasco, Sami Alasfar, Robert A Montgomery, Edward Kraus, Annette M Jackson, Mary S Leffell, Andrea A Zachary
Retrospective studies of angiotensin II type 1 receptor antibodies (AT1R-Ab) and anti-endothelial cell antibodies (AECA) have linked these antibodies to allograft injury. Because rising healthcare costs dictate judicious use of laboratory testing, we sought to define characteristics of kidney transplant recipients who may benefit from screening for non-HLA antibodies. Kidney recipients transplanted between 2011 and 2016 at Johns Hopkins, were evaluated for AT1R-Ab and AECA. Pre-transplant antibody levels were compared to clinical and biopsy indications of graft dysfunction...
February 8, 2018: Human Immunology
Maria Helena Calixto Fernandes, Thomas Schricker, Sheldon Magder, Roupen Hatzakorzian
The incidence of delayed graft function in patients undergoing kidney transplantation remains significant. Optimal fluid therapy has been shown to decrease delayed graft function after renal transplantation. Traditionally, the perioperative volume infusion regimen in this patient population has been guided by central venous pressure as an estimation of the patient's volume status and mean arterial pressure, but this is based on sparse evidence from mostly retrospective observational studies. Excessive volume infusion to the point of no further fluid responsiveness can damage the endothelial glycocalyx and is no longer considered to be the best approach...
January 25, 2018: Critical Care: the Official Journal of the Critical Care Forum
Arthur J Matas, Danielle M Berglund, David M Vock, Hassan N Ibrahim
End stage renal disease (ESRD) is a risk after kidney donation. We sought, in a large cohort of kidney donors to determine the causes of donor ESRD, the interval from donation to ESRD, the role of donor/recipient relationship, and the trajectory of the estimated GFR (eGFR) from donation to ESRD. Between 1/1/1963 thru 12/31/2015, 4030 patients underwent living donor nephrectomy at our center, and have had ascertainment of ESRD status. Of these, 39 have developed ESRD (mean age at ESRD, 62.4 ± 14.1 years; mean interval between donation and ESRD, 27...
January 25, 2018: American Journal of Transplantation
Maureen McCauley, Adam Mussell, David Goldberg, Deirdre Sawinski, Rodolfo N Molina, Ricarda Tomlin, Sahil D Doshi, Peter Abt, Roy Bloom, Emily Blumberg, Sanjay Kulkarni, Gabriela Esnaola, Justine Shults, Carrie Thiessen, Peter P Reese
BACKGROUND: Despite effective antiviral treatment, hundreds of kidneys from deceased donors with hepatitis C virus (HCV) are discarded annually. Little is known about the determinants of willingness to accept HCV-infected kidneys among HCV-negative patients. METHODS: At 2 centers, 189 patients undergoing initial or reevaluation for transplant made 12 hypothetical decisions about accepting HCV-infected kidneys in which we systematically varied expected HCV cure rate, allograft quality and wait-time for an uninfected kidney...
January 18, 2018: Transplantation
Lafaine Grant, Shannan Tujios, Amit G Singal
PURPOSE OF REVIEW: Rates of simultaneous liver kidney (SLK) transplantation have continued to increase despite lack of clear allocation guidelines and outcomes data. The organ procurement and transplantation network (OPTN)/UNOS board approved a new SLK allocation policy to standardize medical eligibility and optimize organ utilization. This review highlights the rationale behind these new selection criteria and posttransplant outcomes in various patient populations. RECENT FINDINGS: Uniform criteria for SLK transplantation were adopted in August 2017 and state SLK should be reserved for select patients with cirrhosis who have chronic kidney disease for longer than 3 months, sustained acute kidney injury, or particular metabolic diseases...
January 19, 2018: Current Opinion in Organ Transplantation
Nicolae Leca
Focal segmental glomerulosclerosis (FSGS) represents a common histologic pattern of glomerular injury associated with a multitude of disease mechanisms. The etiology of FSGS is often classified into primary (idiopathic) and secondary forms in response to genetic abnormalities, infections, toxins, and systemic disorders that lead to adaptive changes, glomerular hyperfiltration, and proteinuria. Our understanding of the pathogenic mechanisms responsible for FSGS was substantially enhanced in recent years because of major advances in the cell biology of the podocyte and parietal epithelial cell...
September 2014: Advances in Chronic Kidney Disease
Sandesh Parajuli, Dana F Clark, Arjang Djamali
Patients with CKD are at increased risk for cardiovascular events, hospitalizations, and mortality. Kidney transplantation (KTx) is the preferred treatment for end-stage kidney disease. Although comorbidities including anemia and bone and mineral disease improve or are even halted after KTx, kidney transplant recipients carry higher cardiovascular mortality risk than the general population, as well as an increased risk of infections, malignancies, fractures, and obesity. When comparing CKD with CKD after transplantation (CKD-T), the rate of decline of estimated glomerular filtration rate (eGFR) is significantly lower in CKD-T...
September 2016: Advances in Chronic Kidney Disease
Enver Akalin
No abstract text is available yet for this article.
January 15, 2018: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
2018-01-22 23:05:13
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