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Renal Transplantation

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199 papers 100 to 500 followers
By Isabel Acosta-Ochoa Nephrology senior staff. Valladolid. Spain
https://www.readbyqxmd.com/read/28905454/management-considerations-in-the-failing-renal-allograft
#1
REVIEW
Tom Lea-Henry, Bobby Chacko
Patients with a failed or failing renal transplant are increasing in number. Graft failure resulting in dialysis re-initiation is not uncommon, yet there are limited data to guide management of these patients. Physician practices vary regarding timing of dialysis initiation and the timing and extent of immunosuppression withdrawal. The risks of immunosuppression withdrawal need to be carefully balanced against the benefits of continuing low-dose therapy. The latter helps minimise the risk of sensitisation and has been proposed to possibly slow the loss of residual renal function; however, the use of common immunosuppressive agents may contribute to cardiovascular disease, malignancy, and infection, the major causes of death following the loss of a renal transplant...
September 14, 2017: Nephrology
https://www.readbyqxmd.com/read/28882367/defining-the-phenotype-of-antibody-mediated-rejection-in-kidney-transplantation-advances-in-diagnosis-of-antibody-injury
#2
REVIEW
Neetika Garg, Milagros D Samaniego, Dana Clark, Arjang Djamali
The diagnostic criteria for antibody-mediated rejection (ABMR) are constantly evolving in light of the evidence. Inclusion of C4d-negative ABMR has been one of the major advances in the Banff Classification in recent years. Currently Banff 2015 classification requires evidence of donor specific antibodies (DSA), interaction between DSA and the endothelium, and acute tissue injury (in the form of microvasculature injury (MVI); acute thrombotic microangiopathy; or acute tubular injury in the absence of other apparent cause)...
August 15, 2017: Transplantation Reviews
https://www.readbyqxmd.com/read/28832239/pre-transplant-histology-does-not-improve-prediction-of-5-year-kidney-allograft-outcomes-above-and-beyond-clinical-parameters
#3
C Traynor, A Saeed, E O'Ceallaigh, A Elbadri, P O'Kelly, D G de Freitas, A M Dorman, P J Conlon, C M O'Seaghdha
Pre-implant kidney biopsy is used to determine suitability of marginal donor kidneys for transplantation. However, there is limited data examining the utility of pre-implant histology in predicting medium term graft outcome. This retrospective study examined kidney transplants over a 10-year period at a single center to determine if pre-implant histology can identify cases of eGFR ≤35 ml/min/1.73m(2) at 5 year follow up beyond a clinical predictive logistic regression model. We also compared outcomes of dual kidney transplants with standard single kidney transplants...
November 2017: Renal Failure
https://www.readbyqxmd.com/read/28832357/recurrent-glomerular-disease-after-kidney-transplantation
#4
Christopher D Blosser, Roy D Bloom
PURPOSE OF REVIEW: With improving short-term kidney transplant outcomes, recurrent glomerular disease is being increasingly recognized as an important cause of chronic allograft failure. Further understanding of the risks and pathogenesis of recurrent glomerular disease enable informed transplant decisions, along with the development of preventive and treatment strategies. RECENT FINDINGS: Multiple observational studies have highlighted differences in rates and outcomes for various recurrent glomerular diseases, although these rates have not markedly improved over the last decade...
August 21, 2017: Current Opinion in Nephrology and Hypertension
https://www.readbyqxmd.com/read/28807264/deconstructing-interstitial-fibrosis-and-tubular-atrophy-a-step-toward-precision-medicine-in-renal-transplantation
#5
Michael Mengel
The prerequisite for successful treatment is an accurate diagnosis, a concept coined precision medicine. Progression of interstitial fibrosis and tubular atrophy is widely considered the natural course for all transplanted kidneys. In this issue, Gosset et al. describe discrete disease entities in individual patients and their contribution to interstitial fibrosis and tubular atrophy and its progression. This represents a major step forward in stratifying patients for targeted treatment trials (i.e., a step toward precision medicine in renal transplantation)...
September 2017: Kidney International
https://www.readbyqxmd.com/read/28738403/developing-consensus-based-priority-outcome-domains-for-trials-in-kidney-transplantation-a-multinational-delphi-survey-with-patients-caregivers-and-health-professionals
#6
MULTICENTER STUDY
Bénédicte Sautenet, Allison Tong, Karine E Manera, Jeremy R Chapman, Anthony N Warrens, David Rosenbloom, Germaine Wong, John Gill, Klemens Budde, Lionel Rostaing, Lorna Marson, Michelle A Josephson, Peter P Reese, Timothy L Pruett, Camilla S Hanson, Donal O'Donoghue, Helen Tam-Tham, Jean-Michel Halimi, Jenny I Shen, John Kanellis, John D Scandling, Kirsten Howard, Martin Howell, Nick Cross, Nicole Evangelidis, Philip Masson, Rainer Oberbauer, Samuel Fung, Shilpa Jesudason, Simon Knight, Sreedhar Mandayam, Stephen P McDonald, Steve Chadban, Tasleem Rajan, Jonathan C Craig
BACKGROUND: Inconsistencies in outcome reporting and frequent omission of patient-centered outcomes can diminish the value of trials in treatment decision making. We identified critically important outcome domains in kidney transplantation based on the shared priorities of patients/caregivers and health professionals. METHODS: In a 3-round Delphi survey, patients/caregivers and health professionals rated the importance of outcome domains for trials in kidney transplantation on a 9-point Likert scale and provided comments...
August 2017: Transplantation
https://www.readbyqxmd.com/read/28705060/usefulness-of-multiparametric-ultrasound-for-evaluating-structural-abnormality-of-transplanted-kidney-can-we-predict-histologic-abnormality-on-renal-biopsy-in-advance
#7
Moon Gyu Yoo, Dae Chul Jung, Young Taik Oh, Sung Yoon Park, Kyunghwa Han
OBJECTIVE: The purpose of this study was to investigate the associations between microscopic abnormalities of transplanted kidneys and sonography-based imaging biomarkers, including elasticity, venous impedance index, arterial resistive index, and size. MATERIALS AND METHODS: Between 2011 and 2015, 159 recipients underwent sonography and biopsy of a transplanted kidney at our institution; 104 adult patients were included in this study. The maximal longitudinal length on gray-scale images, arterial resistive index, and venous impedance index on Doppler images and shear wave velocity on acoustic radiation force impulse imaging or Young modulus on supersonic shear imaging were measured before biopsy...
July 13, 2017: AJR. American Journal of Roentgenology
https://www.readbyqxmd.com/read/28698834/biomarkers-in-renal-transplantation-an-updated-review
#8
REVIEW
Maurizio Salvadori, Aris Tsalouchos
Genomics, proteomics and molecular biology lead to tremendous advances in all fields of medical sciences. Among these the finding of biomarkers as non invasive indicators of biologic processes represents a useful tool in the field of transplantation. In addition to define the principal characteristics of the biomarkers, this review will examine the biomarker usefulness in the different clinical phases following renal transplantation. Biomarkers of ischemia-reperfusion injury and of delayed graft function are extremely important for an early diagnosis of these complications and for optimizing the treatment...
June 24, 2017: World Journal of Transplantation
https://www.readbyqxmd.com/read/28688205/utilization-of-organs-from-donors-according-to-hepatitis-c-antibody-and-nucleic-acid-testing-status-time-for-change
#9
C E Kling, J D Perkins, C S Landis, A P Limaye, L Sibulesky
Previous studies have grouped all donors positive for hepatitis C virus (HCV) antibody (Ab). Only recently has donor HCV nucleic acid testing (NAT) become routine, and the impact of Ab and NAT status on organ utilization is unknown. Using the United Network for Organ Sharing database, we identified 9290 donors from 2015 to 2016 for whom both HCV Ab and NAT data were available and compared organ utilization by HCV status. Overall, 93.8% of donors were Ab negative and NAT negative (Ab-NAT-), 0.15% were Ab negative and NAT positive, 1...
June 8, 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/28684646/association-between-reperfusion-renal-allograft-biopsy-findings-and-transplant-outcomes
#10
Sumit Mohan, Eric Campenot, Mariana C Chiles, Dominick Santoriello, Eric Bland, R John Crew, Paul Rosenstiel, Geoffrey Dube, Ibrahim Batal, Jai Radhakrishnan, P Rodrigo Sandoval, James Guarrera, M Barry Stokes, Vivette D'Agati, David J Cohen, Lloyd E Ratner, Glen Markowitz
Biopsy findings at the time of procurement of deceased donor kidneys remain the most common reason cited for kidney discard. To determine the value of renal allograft histology in predicting outcomes, we evaluated the significance of histologic findings, read by experienced renal pathologists, in 975 postreperfusion biopsy specimens collected from 2005 to 2009 after living donor (n=427) or deceased donor (n=548) renal transplant. We evaluated specimens for the degree of glomerulosclerosis, interstitial fibrosis and tubular atrophy, and vascular disease; specimens with a score of 0 or 1 (scale, 0-3) for each parameter were considered optimal...
July 6, 2017: Journal of the American Society of Nephrology: JASN
https://www.readbyqxmd.com/read/28678346/coagulation-profile-in-patients-with-chronic-kidney-disease-before-and-after-kidney-transplantation-a-retrospective-cohort-study
#11
Jinbeom Cho, Kang Woong Jun, Mi Hyeong Kim, Jeong Kye Hwang, In Sung Moon, Ji Il Kim
BACKGROUND: Patients with chronic kidney disease (CKD) tend to experience both thrombotic and hemorrhagic complications; however, the pathophysiology remains unclear. This study aimed to identify the underlying mechanisms and characteristics of hemostatic problems in patients with CKD and to demonstrate the role of kidney transplantation (KT) in correcting these hemostatic abnormalities. METHODS: In this retrospective observational study, 557 KT recipients who did not receive perioperative plasmapheresis and who did not exhibit graft failure within 1 month after KT were included...
July 5, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/28638611/does-size-matter-kidney-transplant-donor-size-determines-kidney-function-among-living-donors
#12
Meenakshi Narasimhamurthy, Lachlan M Smith, Jason T Machan, Steven E Reinert, Reginald Y Gohh, Lance D Dworkin, Basma Merhi, Nikunjkumar Patel, Michael D Beland, Susie L Hu
BACKGROUND: Kidney donor outcomes are gaining attention, particularly as donor eligibility criteria continue to expand. Kidney size, a useful predictor of recipient kidney function, also likely correlates with donor outcomes. Although donor evaluation includes donor kidney size measurements, the association between kidney size and outcomes are poorly defined. METHODS: We examined the relationship between kidney size (body surface area-adjusted total volume, cortical volume and length) and renal outcomes (post-operative recovery and longer-term kidney function) among 85 kidney donors using general linear models and time-to-chronic kidney disease data...
February 2017: Clinical Kidney Journal
https://www.readbyqxmd.com/read/28665524/rapid-screening-for-malignancy-in-organ-donors-15-year-experience-with-the-verona-alert-protocol-and-review-of-the-literature
#13
Albino Eccher, Luca Cima, Andrea Ciangherotti, Umberto Montin, Paola Violi, Amedeo Carraro, Umberto Tedeschi, Francesco Nacchia, Francesca Fior, Momo Rostand, Luigino Boschiero, Antonietta D'Errico, Aldo Scarpa, Marilena Casartelli-Liviero, Giuseppe Ferrari, Viviana Rodini, Elisabetta Tomaselli, Laura Zampicinini, Francesca Vanzo, Chiara Bovo, Giuseppe Feltrin, Desley Neil, Matteo Brunelli
BACKGROUND: Prevention of transmission of malignancy from donors to recipients is an aim of donor assessment. We report the most stringent interpretation of the Italian National Guidelines. METHODS: A two-step ALERT process was used: ALERT1 consisting of clinical, radiological, and laboratory tests; ALERT2, consisting of intraoperative assessment in suspicious lesions. RESULTS: Four hundred of 506 potential deceased donors entered the ALERT system...
June 30, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/28564126/prehabilitation-for-kidney-transplant-candidates-is-it-time
#14
REVIEW
Xingxing S Cheng, Jonathan N Myers, Glenn M Chertow, Ralph Rabkin, Khin N Chan, Yu Chen, Jane C Tan
Many patients become frail with diminished cardiorespiratory fitness while awaiting kidney transplantation. Frailty and poor fitness powerfully predict mortality, transplant graft survival, and healthcare utilization after kidney transplantation. Efforts to intervene with post-transplant physical therapy have been met with limited success, in large part due to high study dropout. We reviewed the literature on chronic kidney disease and exercise to propose a clinical framework for physical therapy interventions to improve fitness, scheduled for before the transplant...
August 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/28593430/the-prevalence-and-significance-of-renal-perfusion-defects-in-early-kidney-transplants-quantified-using-3d-contrast-enhanced-ultrasound-ceus
#15
Ben Stenberg, M Wilkinson, S Elliott, N Caplan
OBJECTIVES: Vascular complications are one of the most common causes of early kidney transplant dysfunction. Contrast enhanced ultrasound increases sensitivity to vascular changes. The aim of this study was to assess the prevalence and size of vascular abnormalities in early renal transplants using 3D CEUS and the significance of perfusion defects on renal function. METHODS: Ninety-nine renal transplant patients underwent 3D CEUS after surgery to quantify perfusion defects as percentage total renal volume (TRV)...
June 7, 2017: European Radiology
https://www.readbyqxmd.com/read/28583575/long-term-clinical-outcomes-of-kidney-re-transplantation
#16
S M Yeo, Y Kim, S S Kang, W Y Park, K Jin, S B Park, U J Park, H T Kim, W H Cho, S Han
BACKGROUND: Kidney re-transplantation is commonly considered to have a higher immunological risk than first kidney transplantation. Because of the organ shortage and increasing waiting lists, long-term outcomes of kidney re-transplantation are being studied. However, reports of re-transplantation outcomes are not common. We have reported our 30 years of experience with second kidney transplantations. METHODS: Of 1210 kidney transplantations between November 1982 and August 2016 performed in our hospital, 105 were second kidney transplantations (2nd KT)...
June 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28601198/recurrent-glomerulonephritis-after-kidney-transplantation-risk-factors-and-allograft-outcomes
#17
Penelope J Allen, Steve J Chadban, Jonathan C Craig, Wai H Lim, Richard D M Allen, Philip A Clayton, Armando Teixeira-Pinto, Germaine Wong
Recurrent glomerulonephritis after kidney transplantation is a feared complication because it is unpredictable and may have a negative impact on graft outcomes. To better understand this we collected data from the Australia and New Zealand Dialysis and Transplant (ANZDATA) Registry accumulated over 30 years. The incidence, risk factors, and outcomes of recurrent glomerulonephritis in transplant recipients were determined using adjusted Cox proportional hazard and competing risk modeling. A total of 6,597 recipients with biopsy-proven glomerulonephritis as the primary cause of end-stage kidney disease were followed for 51,871 person-years (median duration 7...
June 7, 2017: Kidney International
https://www.readbyqxmd.com/read/28583515/acoustic-radiation-force-impulse-imaging-of-the-transplant-kidney-correlation-between-cortical-stiffness-and-arterial-resistance-in-early-post-transplant-period
#18
H-K Wang, Y-C Lai, Y-H Lin, H-J Chiou, Y-H Chou
BACKGROUND: Acoustic radiation force impulse (ARFI) imaging is a noninvasive imaging modality for quantitative assessment of tissue stiffness. This study utilized ARFI imaging to assess the stiffness of a transplant renal cortex within the first month after renal transplantation and to explore the correlation between the cortical stiffness and arterial resistance of the transplant kidney. METHODS: Forty renal transplant recipients (male/female = 26/14; mean age: 45...
June 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28561006/strategies-for-long-term-preservation-of-kidney-graft-function
#19
REVIEW
Thomas Wekerle, Dorry Segev, Robert Lechler, Rainer Oberbauer
Kidney transplantation has become a routine procedure in the treatment of patients with kidney failure, and requires collaboration of experts from different disciplines, such as nephrology, surgery, immunology, pathology, infectious disease medicine, cardiology, and oncology. Grafts can be obtained from deceased or living donors, with different logistical requirements and implications for long-term graft patency. 1-year graft survival rates are greater than 95% in many centres but improvement of long-term function remains a challenge...
May 27, 2017: Lancet
https://www.readbyqxmd.com/read/28557956/-model-for-early-allograft-function-outperforms-early-allograft-dysfunction-as-a-predictor-of-transplant-survival
#20
Ina Jochmans, Steffen Fieuws, Diethard Monbaliu, Jacques Pirenne
BACKGROUND: The Model of Early Allograft Function (MEAF) grades the severity of liver graft dysfunction. Unlike the categorical early allograft dysfunction (EAD) classification, MEAF is a continuous score, based on bilirubin, international normalized ratio, and alanine aminotransferase within 3 days posttransplant. METHODS: Multivariable regression models were used to validate the MEAF score in 660 liver-only transplants performed between 2000 and 2014. MEAF performance for prediction of transplant survival was compared with that of EAD in univariable and multivariable models by means of Harrell's c-indices, integrated discrimination improvement, and net reclassification improvement...
August 2017: Transplantation
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