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Renal Transplantation

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186 papers 100 to 500 followers
By Isabel Acosta-Ochoa Nephrology senior staff. Valladolid. Spain
https://www.readbyqxmd.com/read/28564126/prehabilitation-for-kidney-transplant-candidates-is-it-time
#1
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 health care 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 drop-out. 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...
May 31, 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
#2
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
#3
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
#4
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
#5
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
#6
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
#7
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 normalised 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 2000-2014. 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...
May 27, 2017: Transplantation
https://www.readbyqxmd.com/read/28544435/solid-renal-masses-in-transplanted-allograft-kidneys-a-closer-look-at-the-epidemiology-and-management
#8
John J Griffith, Katherine A Amin, Nikhil Waingankar, Susan M Lerner, Veronica Delaney, Scott A Ames, Ketan Badani, Michael A Palese, Reza Mehrazin
The objective of this review is to explore the available literature on solid renal masses (SRM) in transplant allograft kidneys to better understand the epidemiology and management of these tumors. A literature review using PubMed was performed according to the PRISMA methodology. Fifty-six relevant studies were identified from 1988-2015. A total of 174 SRMs in 163 patients, were identified with a mean tumor size of 2.75 cm (0.5-9.0cm). Tumor histology was available in 164 (94.3%) tumors: clear cell renal cell carcinoma (RCC) (45...
May 19, 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/28523715/dual-en-bloc-technique-for-adult-renal-transplantation
#9
Kim Chi Tran, David Li, Ali Taqi, Alp Sener, Vivian C McAlister, Patrick P Luke
INTRODUCTION: We describe and provide follow-up for a novel simplified technique permitting dual en-bloc (DEB) transplantation of adult organs using single in situ arterial and venous anastomoses. METHODS: Twenty-two adult DEB transplants were performed at our centre between 2001 and 2012, utilizing 44 kidneys en bloc. Results were compared with 20 solitary transplants from expanded criteria donors (ECD) associated with lower terminal serum creatinines and Remuzzi biopsy scores vs...
May 19, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/28544075/dual-kidney-transplant-techniques-a-systematic-review
#10
Annelise Cocco, Sara Shahrestani, Nicholas Cocco, Ahmer Hameed, Lawrence Yuen, Brendan Ryan, Wayne Hawthorne, Vincent Lam, Henry Pleass
BACKGROUND: Dual kidney transplantation (DKT) was developed in order to improve outcomes from transplantation of extended criteria donors (ECD). This paper examined which surgical techniques have been reported for DKT, and whether any technique had superior patient and graft survival. METHOD: Electronic databases were searched for published studies mapping to MESH terms: ''kidney or renal" AND "transplan*" AND "dual or double". Single case reports; studies of patients less than 18 years old; studies which did not describe the surgical technique; and studies that did not report patient or graft survival were excluded...
May 23, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/28535527/treatment-of-acute-antibody-mediated-rejection
#11
Giorgia Comai, Matteo Ravaioli, Olga Baraldi, Vania Cuna, Lorenzo Gasperoni, Giovanni Liviano D''Arcangelo, Maria Cappuccilli, Antonio D Pinna, Claudio Ronco, Gaetano La Manna
Acute antibody-mediated rejection (AMR) remains an important challenge in the field of kidney transplantation despite the advances in immunosuppressive strategies, and has been recognized as an important cause of allograft dysfunction and graft loss. The treatments of acute AMR are not standardized and poor evidence is currently available on the effectiveness of therapy regimens with combinations of drugs. Standard treatment for acute AMR is based on 3 cornerstones: removal of donor-specific antibodies (DSAs) from the bloodstream, reduction of DSAs synthesis, and inhibition of the interaction between DSAs and human leukocyte antigen antigens on donor's cells...
2017: Contributions to Nephrology
https://www.readbyqxmd.com/read/28535528/chronic-allograft-injury-an-overview-of-pathogenesis-and-treatment-strategies
#12
Hector M Madariaga, Leonardo V Riella
Chronic allograft injury (CAI) remains one of the biggest challenges in transplantation as it directly affects the long-term allograft survival, an area in which the scientific and transplantation communities have struggled to improve outcomes. Therefore, understanding the mechanisms of CAI is paramount to implement preventive measures and novel therapeutic options. In this review, we will address the latest evidence on CAI, potential etiologies and risk factors including non-adherence, antibody-mediated rejection, recurrence of glomerular disease, BK nephropathy, and calcineurin nephrotoxicity...
2017: Contributions to Nephrology
https://www.readbyqxmd.com/read/28535529/looking-into-the-graft-without-a-biopsy-biomarkers-of-acute-rejection-in-renal-transplantation
#13
Andrea Angeletti, Paolo Cravedi
Immunosuppression in kidney transplantation is still largely driven by center-specific protocols and adjusted according to the presence of graft dysfunction, drug toxicity or infection. Due to the current inability to titrate immunosuppression to the needs of every single patient, this approach is burdened by an increased risk of under or over-immunosuppression. To extend allograft survival, immunosuppression should be decided based on reliable biomarkers capable of quantifying the alloimmune response and/or noninvasively diagnosing acute rejection...
2017: Contributions to Nephrology
https://www.readbyqxmd.com/read/28515172/cross-sex-transplantation-alters-gene-expression-and-enhances-inflammatory-response-in-the-transplanted-kidneys
#14
Lei Wang, Jiangping Song, Shaohui Wang, Jacentha Buggs, Rongjun Chen, Jie Zhang, Liqing Wang, Song Rong, Wenbin Li, Jin Wei, Ruisheng Liu
Kidney transplantation (KTX) is a life-saving procedure for patients with end-stage renal disease. Expression levels of many genes in kidney vary between males and females which may play an essential role in the sex differences in graft function. However, whether these differences are affected after cross-sex-KTX is unknown. In the present study, we assessed post-operative changes in genotype, function and inflammatory responses of the grafts in same-sex and cross-sex-KTX. Single kidney transplants were performed between same and different sex C57BL/6 mice paired into 4 combination groups: female donor/female recipient (F/F); male donor/male recipient (M/M); female donor/male recipient (F/M); and male donor/female recipient (M/F)...
May 17, 2017: American Journal of Physiology. Renal Physiology
https://www.readbyqxmd.com/read/28511172/donor-specific-anti-human-leukocyte-antigens-antibodies-acute-rejection-renal-function-and-histology-in-kidney-transplant-recipients-receiving-tacrolimus-and-everolimus
#15
Alexandra Ferreira, Claudia Felipe, Marina Cristelli, Laila Viana, Geovana Basso, Suelen Stopa, Juliana Mansur, Mayara Ivani, Adrieli Bessa, Priscila Ruppel, Wilson Aguiar, Erika Campos, Maria Gerbase-DeLima, Henrique Proença, Helio Tedesco-Silva, José Medina-Pestana
BACKGROUND: This analysis compared efficacy, renal function, and histology in kidney transplant recipients receiving tacrolimus (TAC) combined with everolimus (EVR) or mycophenolate (MPS). METHODS: This was a retrospective analysis from a randomized trial in kidney transplant recipients who received a single 3 mg/kg dose of rabbit antithymocyte globulin (r-ATG), TAC, EVR, and prednisone (PRED; r-ATG/EVR, n = 85), basiliximab (BAS), TAC, EVR, and PRED (BAS/EVR, n = 102) or BAS, TAC, MPS, and PRED (BAS/MPS, n = 101)...
2017: American Journal of Nephrology
https://www.readbyqxmd.com/read/28503746/application-of-ultrasound-elastography-for-chronic-allograft-dysfunction-in-kidney-transplantation
#16
REVIEW
Zijie Wang, Haiwei Yang, Chuanjian Suo, Jifu Wei, Ruoyun Tan, Min Gu
Interstitial fibrosis is the main characteristic of chronic allograft dysfunction, which remains the key factor affecting long-term allograft survival after kidney transplantation. Ultrasound elastography (UE), including real-time elastography, transient elastography, and acoustic radiation force impulse, has been applied widely in breast, thyroid, and liver diseases, especially in the assessment of liver fibrosis. Recently, numerous studies have reported the efficacy of UE methods in evaluating renal allograft fibrosis...
May 15, 2017: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
https://www.readbyqxmd.com/read/28504869/kidney-outcomes-in-patients-with-liver-cirrhosis-and-chronic-kidney-disease-receiving-an-orthotopic-liver-transplant-alone
#17
Neeraj Singh, Shahab Ahmadzadeh, Hosein Shokouh-Amiri, Yasir Qazi, Adrian Sequeira, Hrishikesh Samant, Robert McMillan, Gazi B Zibari
Kidney transplant in patients with liver cirrhosis and non-dialysis chronic kidney disease (CKD) is controversial. We report 14 liver cirrhotic patients who had persistently low MDRD-6 estimated-glomerular filtration rate (e-GFR) < 40 ml/min/1.73m2 for ≥ 3 months and underwent either liver transplant alone (LTA) (n=9) or simultaneous liver-kidney transplant (SLKT) (n=5). Pre-transplant, patients with LTA compared with SLKT had lower serum creatinine (2.5±0.73 vs. 4.6±0.52 mg/dl, P= 0.001), higher MDRD-6 e-GFR (21...
May 15, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/28452165/cutaneous-toxicities-from-transplant-related-medications
#18
M Ilyas, O R Colegio, B Kaplan, A Sharma
Despite the abundance of information on cutaneous malignancies associated with solid organ transplantation in the transplant literature, there is limited information regarding non-malignant skin changes after transplantation. There are numerous skin toxicities secondary to immunosuppressive and other transplant-related medications that can vary in presentation, severity, and prognosis. In order to limit associated morbidity and mortality, SOTR care providers should effectively identify and manage cutaneous manifestations secondary to drug toxicity...
April 27, 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/28446536/donor-specific-antibodies-in-kidney-transplant-recipients
#19
REVIEW
Rubin Zhang
Donor-specific antibodies have become an established biomarker predicting antibody-mediated rejection. Antibody-mediated rejection is the leading cause of graft loss after kidney transplant. There are several phenotypes of antibody-mediated rejection along post-transplant course that are determined by the timing and extent of humoral response and the various characteristics of donor-specific antibodies, such as antigen classes, specificity, antibody strength, IgG subclasses, and complement binding capacity...
April 26, 2017: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/28445619/mtor-inhibitors-and-risk-for-chronic-antibody-mediated-rejection-after-kidney-transplantation-where-are-we-now
#20
REVIEW
Philippe Grimbert, Olivier Thaunat
Antibody-mediated rejection (AMR) usually starts with generation of donor-specific anti-HLA antibodies (DSA), arising from a B-cell response to antigen recognition. In vitro and preclinical data demonstrate that mammalian target of rapamycin (mTOR) inhibition attenuates the mTOR-mediated intracellular signaling pathway involved in AMR-related kidney damage. The limited available data from immunological studies in kidney transplant patients, however, have not shown such effects in vivo. In terms of clinical immunosuppression, the overriding influence on rates of de novo DSA (dnDSA) or AMR - regardless of the type of regimen - is patient adherence...
April 26, 2017: Transplant International: Official Journal of the European Society for Organ Transplantation
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