The January 2018 issue of the Journal of the American Medical Association features the article Association of Race and Ethnicity with Live Donor Kidney Transplantation in the United States From 1995 to 2014 authored by Tanjala S. Purnell and colleagues including Lisa Cooper, Deidra Crews and Ebony Boulware from the DOM. The study aims to estimate changes over time in racial/ethnic disparities in live donor kidney transplantation (LDKT) in the U.S. utilizing data from the Scientific Registry of Transplant Recipients between January 1995 to December 2014, with follow-up thorough December 2016. The articles notes that their findings exist amidst numerous interventions to address racial/ethnic disparities in LDKT including addressing barriers to knowledge, cultural concerns, attitudes, beliefs, behavior and policies to address economic barriers.. Of the over 450,000 adult kidney transplant candidates whose data was analyzed between 1995 and 2014, 13.1 percent received LDKT. The major findings from ...

TY - JOUR. T1 - Posttransplant lymphoproliferative disorders in adult and pediatric renal transplant patients receiving tacrolimus-based immunosuppression. AU - Shapiro, Ron. AU - Nalesnik, Michael. AU - McCauley, Jerry. AU - Fedorek, Sheila. AU - Jordan, Mark L.. AU - Scantlebury, Velma P.. AU - Jain, Ashok. AU - Vivas, Carlos. AU - Ellis, Demetrius. AU - Lombardozzi-Lane, Susanne. AU - Randhawa, Parmjeet. AU - Johnston, James. AU - Hakala, Thomas R.. AU - Simmons, Richard L.. AU - Fung, John J.. AU - Starzl, Thomas E.. PY - 1999/12/27. Y1 - 1999/12/27. N2 - Between March 27, 1989 and December 31, 1997, 1316 kidney transplantations alone were performed under tacrolimus-based immunosuppression at our center. Posttransplant lymphoproliferative disorders (PTLD) developed in 25 (1.9%) cases; the incidence in adults was 1.2% (15/1217), whereas in pediatric patients it was 10.1% (10/99; P,.0001). PTLD was diagnosed 21.0±22.5 months after transplantation, 25.0±24.7 months in adults and 14.4±18.2 ...

Live Donor Kidney Transplantation: Updates in Paired Kidney Exchange Miguel Tan, MD, FRCSC Surgical Director, Kidney & Pancreas Transplantation Piedmont Transplant Institute Outline 1. 2. 3. Current statistics for kidney transplantation in the United States Living donor outcomes Paired exchange, impact, logistics and challenges Patients on the waiting list on December 31 of the year (active listings only) Organ supply continues to be a problem in kidney transplantation Almost 100 000 patients on waiting list Average waiting time to transplant 4- 5 years 4% of potential recipients die while waiting on list annually Transplants performed during the year (adult & pediatric combined) Deceased kidney donation rates Organ discard rate for organs recovered for transplantation Possible reasons for lack of growth of supply include -lack of education on donation options ie. living donation, paired exchange, desensitization -Increasing rate of morbid obesity and diabetes resulting poorer quality of organs ...

TY - JOUR. T1 - There are no differences in pretransplant characteristics of individuals receiving simultaneous pancreas-kidney transplant and individuals with type 1 diabetes mellitus receiving living-related kidney transplant. AU - Donigan, L.. AU - Stevens, R. B.. AU - Wrenshall, L.. AU - Larsen, J.. PY - 2004/5. Y1 - 2004/5. N2 - Abstract Simultaneous pancreas-kidney transplantation (SPK) recipients have longer survival compared to type 1 diabetes mellitus (DM1) cadaveric kidney recipients. However, DM1 living-related kidney transplant (KTX-LR) recipients have the same mortality as SPK recipients. It is unknown whether cardiovascular (CVD) risk factors pretransplant are similar between the two groups, SPK and DM1 KTX-LR. We analyzed pretransplant characteristics of SPK recipients (n = 39) and DM1 KTX-LR/living unrelated (LUR) recipients (KTX-LR/LUR, n = 20). In individuals who had multiple transplants, only pretransplant data from the first transplant was used. As all characteristics of ...

Living donor kidney transplantation , Living donor kidney transplantation , کتابخانه الکترونیک و دیجیتال - آذرسا

The purpose of this review was to investigate this in more detail-in particular the choice between a simultaneous pancreas-kidney transplantation and

Objective. In kidney transplanation, some upper pole branches are too thin to be reconstructed. The impact of graft thin upper pole arterial branch ligation on adult living donor kidney transplantation remains to be investigated. Methods. Between January 2008 and May 2015, 604 adult living donor kidney transplants were performed. 462 kidney grafts with single arteries (Single artery group), 125 kidney grafts with reconstructed arteries (Reconstruction group), and 17 kidney grafts with ligated thin upper pole arterial branch (Ligation group) were enrolled. To evaluate the efficacy of thin upper pole ligation, Ligation group was compared with other groups. Characteristics of donors, recipients, and operation, recipient eGFR, and complications were investigated.. Results. Warm ischemic time and total ischemic time were significantly longer in Reconstruction group ...

Infections have increased in simultaneous pancreas/kidney transplant recipients (SPKTRs) with CMV-infection being the most important viral infection with adverse impact on patient and allograft outcomes. A comparison of CMV-infection between SPKTRs and kidney transplant recipients (KTRs), and the association of CMV-infection with other infectious complications in SPKTRs, however, remains scarcely described.. Here, we studied all primary SPKTRs and primary deceased-donor KTRs (,65 years) at our transplant center between 2008 and 2015 for the development of active CMV-infection. 21 of 62 SPKTRs (33.9%) and 90 of 335 KTRs (26.9%) were diagnosed with CMV viremia. A control group of 41 SPKTRs without CMV viremia was used for comparison.. SPKTRs showed an increased incidence of active CMV-infection compared to KTRs. SPKTRs were more likely to develop CMV-disease, CMV pneumonia, recurrent CMV-infection, higher initial and peak CMV-loads, and more need for intravenous antiviral therapy compared to KTRs ...

Laparoscopic living donor kidney transplantation. Laparoscopic nephrectomy for kidney transplant has been established as a mainstream procedure both in Europe and the US because it allows donors to resume their daily activities very quickly.. In 2015 we performed the first laparoscopic living donor kidney transplant in a male patient following laparotomy. This 68-year-old patient had previously undergone surgery due to a car accident. Two 5mm trocars and one 10mm trocar were placed on the left midclavicular line, from the costal arch towards the anterior superior iliac spine and, a 10 mm trocar has been placed in the suprapubic area, which was replaced by a gelport for transplant removal.. Surgery lasted three hours. Warm ischemia time was three minutes.. The graft was immediately placed and the recipient had immediate diuresis with beginning of the renal function.. The postoperative course of the donor was unhindered and he was discharged from hospital on the fourth postoperative day.. The ...

TY - JOUR. T1 - A multicenter cohort study of potential living kidney donors provides predictors of living kidney donation and non-donation. AU - Bailey, Pippa. AU - Tomson, Charles. AU - MacNeill, Stephanie. AU - Marsden, Ann. AU - Cooke, Rhian. AU - Cook, Dominique. AU - Cooke, Rhian. AU - Biggins, Fiona. AU - OSullivan, Jim. AU - Ben-Shlomo, Yoav. PY - 2017/11. Y1 - 2017/11. N2 - This multicentre prospective potential living kidney donor cohort study investigated which sociodemographic and other factors predict progression to living kidney donation or donor withdrawal, as little is known on this topic. Data were collected on individuals undergoing living donor assessment at 7 UK hospitals from 01/08/14 to 31/1/16. Multivariable logistic regression was used to explore the relationships between donor and recipient characteristics and likelihood of kidney donation. 805 individuals presented for directed donation to 498 intended recipients. 112 intended recipients received a transplant from a ...

We are a leading center for living donor kidney transplant and incompatible blood type kidney transplant in adult and pediatric kidney transplant patients.

Live donor kidney transplantation has become a widely sought treatment by patients with end-stage renal failure. As the outcome for the genetically and emotionally related live donor transplants is the same, this review considers live kidney transplantation from the broad scope of current international practice. Unrelated live donor transplantation can now be performed for incompatible donor recipient pairs via a simultaneous paired kidney donation. However, acceptance of the scientific data that an unrelated live donor transplant can now be performed successfully should not be misconstrued as an acceptance that an unrelated kidney may be purchased via a vendor sale. At a recent World Health Organization (WHO) conference of Middle East transplant professionals a statement of unequivocal opposition to commercialism was drafted. In the United States, the Institute of Medicine has recently published a significant report that affirms the legal prohibition of organ sales. These documents are in ...

TY - JOUR. T1 - Long-term kidney allograft function and survival in prednisone-free regimens. T2 - Tacrolimus/mycophenolate mofetil versus tacrolimus/sirolimus. AU - Chhabra, Darshika. AU - Skaro, Anton I.. AU - Leventhal, Joseph R.. AU - Dalal, Pranav. AU - Shah, Gaurav. AU - Wang, Edward. AU - Gallon, Lorenzo. PY - 2012/3/1. Y1 - 2012/3/1. N2 - Background and objectives: The optimal maintenance immunosuppressive regimen to improve long-term renal allograft function and graft survival is yet to be determined. Design, setting, participants, & measurements: This observational study prospectively compared tacrolimus/sirolimuswith tacrolimus/mycophenolatemofetil in renal transplant recipients using a prednisone-free regimen with over 8.5 years of follow-up. Patients received methylprednisonlone and anti-IL2 receptor antagonist (Basiliximab) induction and were blindly randomized to either the tacrolimus/mycophenolate mofetil (n=45) or tacrolimus/sirolimus (n=37) groups. Outcomemeasures included ...

TY - JOUR. T1 - Is anuria prior to pediatric renal transplantation associated with poor allograft outcomes?. AU - Alam, Zaheer. AU - VanderBrink, Brian A.. AU - Brewer, Nathalie. AU - Hooper, David. AU - Tiao, Greg. AU - Alonso, Maria. AU - Nathan, Jaimie. AU - DeFoor, W. Robert. AU - Sheldon, Curtis. AU - Reddy, Pramod P.. N1 - Publisher Copyright: © 2019 Wiley Periodicals, Inc.. PY - 2019. Y1 - 2019. N2 - Introduction: Anuria from end-stage renal disease leads to a defunctionalized bladder and may pose technical challenges at the time of renal transplantation. Anurias effect on bladder function after renal transplantation is considered to be minimal in adults, although a paucity of evidence is available in children. The purpose of this study was to examine the effects of anuria prior to pediatric renal transplantation for ESRD due to medical renal disease on allograft outcome. Methods: We performed a retrospective review of pediatric patients who underwent renal transplantation for medical ...

TY - JOUR. T1 - Urine proteomic profiling for biomarkers of acute renal transplant rejection.. AU - Liang, Shu Ling. AU - Clarke, William. PY - 2010. Y1 - 2010. N2 - Acute allograft rejection is a serious impediment to long-term success in renal transplantation. Early detection of rejection is crucial for treatment of rejection, and can help avoid long-term effects such as chronic rejection or loss of the transplanted organ. The current diagnostic paradigm is a combination of clinical presentation, biochemical measurements (serum creatinine), and needle biopsy. There are significant efforts underway to find alternate biomarkers for early detection of acute rejection, including protein profiling of urine by mass spectrometry. One approach for protein profiling is to use affinity mass spectrometry - we describe a method for this using ProteinChips and SELDI-TOF mass spectrometry.. AB - Acute allograft rejection is a serious impediment to long-term success in renal transplantation. Early detection ...

The development of the meeting and workgroups, rationale for the topics, process of creating consensus, and top recommendations are outlined in more detail in an overview meeting report (3). Recommendations included strategies to educate patients with CKD and ESRD, potential living donors, and the public; efficiencies in processes; policy initiatives; and a research agenda. An important and recurring theme was the importance of coordination and communication between providers throughout the continuum of disease to most effectively reach patients and their support systems. This moving points edition will address consensus conference recommendations for a collaborative approach to care, education, and access to improve overall practice in LDKT and LKD.. Five articles address how transplant centers and community nephrology care teams can partner for improved practices. In the first article, Living Donor Kidney Transplantation: Improving Education Outside of Transplant Centers about Live Donor ...

Slow graft function after pediatric renal transplantation from volunteer live donors , Slow graft function after pediatric renal transplantation from volunteer live donors , کتابخانه دیجیتالی دانشگاه علوم پزشکی و خدمات درمانی شهید بهشتی

TY - JOUR. T1 - Genomics of chronic allograft injury. AU - Akalin, Enver. AU - OConnell, Philip J.. N1 - Copyright: Copyright 2011 Elsevier B.V., All rights reserved.. PY - 2010/12. Y1 - 2010/12. N2 - Chronic allograft injury (CAI) is common after kidney transplantation in which immunological (e.g., acute and chronic cellular and antibody-mediated rejection) and nonimmunological factors (e.g., donor-related factors, ischemia-reperfusion injury, polyoma virus, hypertension, and calcineurin inhibitor nephrotoxicity) have a role. Despite the new Banff pathological classification, histopathological diagnosis is still far from being the gold standard to understand the exact mechanisms in the development of CAI, which may lead to appropriate treatment. Microarray is a powerful technology that detects thousands of genes simultaneously and might be an important tool in elucidating patterns for mechanism, diagnosis, prognosis, and treatment of complex, multifactorial diseases, such as CAI. In this ...

Mesenchymal stem cells (MSCs) are multi-potent non-hematopoietic progenitor cells possessing an immune-regulatory function, with suppression of proliferation of activated lymphocytes. In this study, adult living donor kidney transplantation (LDKT) recipients were given MSCs derived from the donor bone marrow to evaluate the safety and the feasibility of immunological changes related to the intra-osseous injection of MSC into the bone marrow. MSCs were derived from negative HLA cross-match donors. Donor bone marrow was harvested 5 weeks prior to KT. At the time of transplantation, 1 x 106 cell/kg of donor MSC was directly injected into the bone marrow of the recipients right iliac bone. Patients clinical outcomes, presence of mixed chimerism by short tandem repeat polymerase chain reaction, analysis of plasma FoxP3 mRNA and cytokine level, and mixed lymphocyte reaction (MLR) were performed. Seven patients enrolled in this study and received donor MSC injections simultaneously with LDKT. The median age

Compared with kidney transplantation alone, simultaneous pancreas-kidney (SPK) transplantation was associated with an almost twofold lower 10-year mortality among type 1 diabetics, in a retrospective study.. The study included all 2,796 patients with type 1 diabetes in the Netherlands who started renal replacement therapy or received a first kidney transplant between 1986 and 2016. As reported in Diabetes Care, of the 996 who received new kidneys, 42% received a deceased-donor kidney; 16%, a living-donor kidney; and 42%, an SPK transplant. Crude survival was highest in SPK recipients and lowest in recipients of a deceased-donor kidney. Median survival time was 7.3 years for deceased-donor kidney recipients; 10.5 years for living-donor kidney recipients; and 16.5 years for SPK recipients.. @media (min-width:500px){#social{padding:0 0 15px 67px}#link{display:none!important}#facebook{padding:0 29px 0 24px}}@media screen and ...

A living donor kidney transplant takes an organ from a living donor and transplants it to the recipient. Learn more about living kidney donation here.

A living donor kidney transplant takes an organ from a living donor and transplants it to the recipient. Learn more about living kidney donation here.

TY - JOUR. T1 - Psychiatric and psychological evaluation in living donor kidney transplantation: a single center experience. T2 - Giornale italiano di nefrologia : organo ufficiale della Societa italiana di nefrologia. AU - Martinelli, V.. AU - Gregorini, M.. AU - Erasmi, F.. AU - Politi, P.. AU - De Pasquale, C.. AU - Pistorio, M.L.. AU - Abelli, M.. AU - Ticozzelli, E.. AU - Chiappedi, M.. AU - Pietrabissa, A.. AU - Rampino, T.. N1 - Export Date: 21 March 2021. PY - 2021. Y1 - 2021. M3 - Article. VL - 38. JO - G Ital Nefrol. JF - G Ital Nefrol. SN - 1724-5990. IS - 1. ER - ...

TY - JOUR. T1 - The Association of 25-Hydroxyvitamin D Levels with Late Cytomegalovirus Infection in Kidney Transplant Recipients. T2 - The Wisconsin Allograft Recipient Database. AU - Astor, Brad C.. AU - Djamali, Arjang. AU - Mandelbrot, Didier A.. AU - Parajuli, Sandesh. AU - Melamed, Michal L.. PY - 2019/8/1. Y1 - 2019/8/1. N2 - Background. Cytomegalovirus (CMV) infection is a major cause of morbidity and mortality in kidney transplant recipients. Vitamin D has an integral role in proper immune function, and deficiency is common among kidney transplant recipients. It remains unclear whether 25-hydroxyvitamin D [25(OH)D] level is associated with CMV infection in kidney transplant recipients. Methods. We examined the relationship between 25(OH)D levels, measured at least 6 months posttransplant, and subsequent CMV infection in 1976 recipients free of prior CMV infection. Results. Of 1976 recipients, 251 (12.7%) were vitamin D deficient [25(OH)D ,20 ng/mL] and 548 (27.7%) were insufficient ...

R SHINGDE1, V CALISA1, JC CRAIG2, JR CHAPMAN3, AC WEBSTER3, H. PLEASS3, P OCONNEL3L, R ALLEN3, P ROBERTSON3, L YUEN3, K KABLE3, B NANKIVELL3, N ROGERS3, G. WONG2,3. 1Centre for Kidney Research, The Childrens Hospital at Westmead, Westmead; 2Sydney School of Public Health, University of Sydney, Sydney; 3Centre for Transplant and Renal Research, Westmead Hospital, Westmead. Aim: To compare the absolute and relative health gains and costs of simultaneous pancreas kidney (SPK) with deceased donor kidney alone transplantation and dialysis in patients with type 1 diabetes mellitus (DM) and end-stage kidney disease (ESKD).. Background: The long-term costs and health benefits of SPK transplantation, compared to dialysis and deceased donor kidney alone transplant are unclear in this setting.. Methods: Two deterministic Markov models comparing patient survival in patients with Type I DM and ESKD who were either waitlisted on dialysis, received a SPK or deceased donor kidney alone transplantation were ...

Ethics of Living Donor Kidney Transplantation Interviewer: Quentin Cooper Interviewees: Mr Andrew Ready, Trustee and Lead Surgeon of TLC, Dr Shazia Shabir, Consultant Nephrologist at University Hospitals Birmingham and TLC volunteer, and Dr Dwomoa Adu, Consultant Nephrologist at Korle Bu Hospital, Accra, Ghana, and TLC Trustee Welcome to this TLC podcast in which science journalist,…

Understand more about why beliefs about organ donation within different communities may impact on decisions about living donor kidney transplantation amongst people from different ethnic backgrounds.. ...

TY - JOUR. T1 - Effects of dipeptidyl peptidase-4 inhibitors on hyperglycemia and blood cyclosporine levels in renal transplant patients with diabetes. T2 - A pilot study. AU - Bae, Jaehyun. AU - Lee, Min Jung. AU - Choe, Eun Yeong. AU - Jung, Chang Hee. AU - Wang, Hye Jin. AU - Kim, Myoung Soo. AU - Kim, Yu Seun. AU - Park, Joong Yeol. AU - Kang, Eun Seok. PY - 2016/3/1. Y1 - 2016/3/1. N2 - Background: The use of dipeptidyl peptidase-4 (DPP-4) inhibitors is increasing among renal transplant patients with diabetes. However, the glucose-lowering efficacies of various DPP-4 inhibitors and their effects on blood cyclosporine levels have not been fully investigated. We compared the glucose-lowering efficacies of DPP 4 inhibitors and evaluate their effects on the blood levels of cyclosporine in renal transplant recipients with diabetes. Methods: Sixty-five renal allograft recipients who received treatment with DPP-4 inhibitors (vildagliptin, sitagliptin, or linagliptin) following kidney transplant ...

TY - JOUR. T1 - Polyomavirus BK Replication in De Novo Kidney Transplant Patients Receiving Tacrolimus or Cyclosporine: A Prospective, Randomized, Multicenter Study. AU - Citterio, Franco. AU - Hirsch, H. H.. AU - Vincenti, F.. AU - Friman, S.. AU - Tuncer, M.. AU - Wiecek, A.. AU - Scheuermann, E. H.. AU - Klinger, M.. AU - Russ, G.. AU - Pescovitz, M. D.. AU - Prestele, H.. PY - 2013. Y1 - 2013. N2 - Polyomavirus BK (BKV)-associated nephropathy causes premature kidney transplant (KT) failure. BKV viruria and viremia are biomarkers of disease progression, but associated risk factors are controversial. A total of 682 KT patients receiving basiliximab, mycophenolic acid (MPA), corticosteroids were randomized 1:1 to cyclosporine (CsA) or tacrolimus (Tac). Risk factors were analyzed in 629 (92.2%) patients having at least 2 BKV measurements until month 12 posttransplant. Univariate analysis associated CsA-MPA with lower rates of viremia than Tac-MPA at month 6 (10.6% vs. 16.3%, p = 0.048) and 12 ...

Design: Randomized prospective study. Setting: University Hospital with an active kidney transplantation program. Patients: Adult kidney transplant recipients. Interventions: Kidney transplant recipients with asymptomatic bacteriuria will be randomly assigned to be treated with antibiotics or to be followed without antibiotic therapy.. Measurements: Urine cultures will be collected weekly during the first month after transplantation, every 2 weeks until three months after transplantation, every month until 6 months after transplantation and every 3 months until 12 months after transplantation. Urine culture will be as well collected if urinary symptoms appeared.. Primary end points: To determine in both groups: the incidence of pyelonephritis.. Secondary end points: To determine outcomes in both groups (renal function, hospitalization, rejection, graft loss, opportunistic infections and mortality) and infection by multiresistant microorganisms. ...

TY - JOUR. T1 - The power of renal function estimation equations for predicting long-term kidney graft survival a retrospective comparison of the chronic kidney disease epidemiology collaboration and the modification of diet in renal disease study equations. AU - Choi, Hoon Young. AU - Joo, Dong Jin. AU - Song, Mi Kyung. AU - Kim, Myoung Soo. AU - Park, Hyeong Cheon. AU - Kim, Yu Seun. AU - Kim, Beom Seok. N1 - Publisher Copyright: © 2016 Wolters Kluwer Health, Inc. All rights reserved.. PY - 2016. Y1 - 2016. N2 - Evaluation of renal function using an accurate estimation equation is important for predicting long-term graft survival. We designed this retrospective cohort study to evaluate the predictive power of renal function estimation by the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) and the Modification of Diet in Renal Disease (MDRD) study equations for graft survival. We reviewed data of 3290 adult kidney transplant recipients who underwent transplantation at a single ...

Critical evaluation of radiolabeled lymphocytes to detect acute renal transplant rejection in a large animal model. - Get your full text copy in PDF #4818

Background: Kidney transplant (Tx) patients present a reduced cardiovascular (CV) mortality in comparison to the dialysis population, but in comparison to the general population, it is still several-fold higher. Methods: We studied risk factors for CV disease in a group of 38 patients (50% males, median age 36 years) who underwent a living donor Tx at the baseline and after 3 ± 1 and 9 ± 2 months. Results: The prevalence of overweight increased from 26 to 54% after Tx (p | 0.001). The mean systolic blood pressure decreased significantly after the Tx (148 ± 27.6 vs. 126 ± 12.7 mm Hg). There was a significant increase in LDL (97 ± 30 vs. 114 ± 35) and hematocrit (33.8 ± 4.4 to 42 ± 5.7%) levels and a significant reduction in fibrinogen levels (394 ± 91 vs. 366 ± 100 mg/dl) after 9 months as compared to the baseline. Obesity and dislipidemia were significantly correlated with inflammation. Significant changes in left ventricle mass index (293 ± 116 vs. 241 ± 96) were observed after the Tx.

TY - JOUR. T1 - Venous thromboembolic complications after kidney and kidney-pancreas transplantation. T2 - A multivariate analysis. AU - Humar, A.. AU - Johnson, E. M.. AU - Gillingham, K. J.. AU - Sutherland, D. E.. AU - Payne, W. D.. AU - Dunn, D. L.. AU - Wrenshall, L. E.. AU - Najarian, J. S.. AU - Gruessner, R. W.. AU - Matas, A. J.. PY - 1998/1/27. Y1 - 1998/1/27. N2 - Background: We reviewed the incidence of and risk factors for venous thromboembolic complications in our population of kidney (KTx) and simultaneous kidney-pancreas transplant (SPK) recipients. methods: Information was collected retrospectively from a database on 1833 KTx and 276 SPK recipients who underwent transplant surgery between January 1985 and August 1995. Results. The incidence of deep venous thrombosis (DVT) was 6.2%(n = 132), with significantly higher rates after SPK (18.1%) vs. KTx (4.5%) (P,0.001). The number of DVT episodes was highest in the first month; 17.5% occurred during this tine. For KTx recipients, ...

TY - JOUR. T1 - Association of prevalent vascular disease with allograft failure and mortality in live-donor kidney transplant recipients - a retrospective cohort study. AU - Mainra, Rahul. AU - Wong, Germaine. AU - Pilmore, Helen. AU - Lim, Wai H.. PY - 2019/6/26. Y1 - 2019/6/26. N2 - Limited data exist regarding the impact of prevalent vascular disease after live-donor kidney transplantation. We aimed to determine the associations between the number of prevalent vascular diseases, allograft, and patient outcomes following live-donor transplantation. This cohort study used data from the Australia and New Zealand Dialysis and Transplant Registry. Rates between recipients of live-donor kidney transplants ± prevalent vascular disease prior to transplantation were calculated. The associations between vascular disease, allograft failure, and all-cause mortality were assessed using Cox regression modeling. Kaplan-Meier proportions were used to calculate all-cause mortality and death with a function ...

TY - JOUR. T1 - Sero-molecular evaluation of human cytomegalovirus disease in renal transplant rejection.. AU - Kishore, Janak. AU - Mukhopadhyay, Chiranjoy. AU - Savitri, AU - Ayyagari, Archana. AU - Sharma, Rakesh Kumar. PY - 2004/1/1. Y1 - 2004/1/1. N2 - Cytomegalovirus (CMV) is the most common viral pathogen in renal transplant recipients resulting in graft rejection. The prevalence of CMV disease and renal graft rejection is not well studied in India. Sequential specimens from 32 renal allograft recipients were examined by using CMV IgM specific mu capture ELISA and DNA by PCR. Twelve of the 32 patients were CMV IgM positive and out of 12 patients, 9 had rejection and 4 experienced CMV disease. CMV IgM specific mu capture ELISA helped in diagnosis of CMV disease, though it is less sensitive in detection of rejection. PCR itself was proved not sensitive enough in detecting either CMV disease or rejection. At present, optimal laboratory detection of CMV infection in these patients can be ...

TY - JOUR. T1 - Use of Ultrasound and Cystoscopically Guided Pancreatic Allograft Biopsies and Transabdominal Renal Allograft Biopsies. T2 - Safety and Efficacy in Kidney-Pancreas Transplant Recipients. AU - Kuhr, Christian S.. AU - Davis, Connie L.. AU - Barr, Darlene. AU - McVicar, John. AU - Perkins, James D.. AU - Bachi, Carlos E.. AU - Alpers, Charles E.. AU - Marsh, Christopher L.. PY - 1995. Y1 - 1995. N2 - The use of allograft biopsies to guide treatment after solid organ transplantation is a valuable tool in the detection and treatment of rejection. Prior development and use of the cystoscopically guided pancreatic allograft biopsy have allowed for more accurate and timely diagnosis of pancreatic allograft dysfunction, possibly contributing to our 1-year pancreas graft, renal allograft and patient survival rates of 87.1%, 88.5% and 96.8%, respectively. We reviewed our experience, examining efficacy and complication rates of pancreas and kidney biopsies in 31 cadaveric pancreas or ...

Pre-transplant nephrectomy is performed to reduce risks to graft and recipient. The aims of this study were to evaluate (1) indications, surgical approach, and morbidity of native nephrectomy and (2) the effects of kidney removal on clinical and biological parameters. This study was designed as a single-center retrospective cohort study in which 49 consecutive patients with uni- or bilateral native nephrectomies were identified from a total of 126 consecutive graft recipients in our pediatric kidney transplantation database between 1992 and 2011. Demographic, clinical, and laboratory details were extracted from charts and electronic records, including operation reports and pre- and post-operative clinic notes. Of the 49 nephrectomized patients, 47% had anomalies of the kidneys and urinary tract, 22% had cystinosis, 12% had focal segmental glomerulosclerosis, and 6% had congenital nephrotic syndrome. Nephrectomy decisions were based on clinical judgment, taking physiological and psychosocial aspects into

TY - JOUR. T1 - Isolated heart and liver transplant recipients are at low risk for polymavirus BKV nephropathy. AU - Puliyanda, Dechu P.. AU - Amet, Nurmamet. AU - Dhawan, Archana. AU - Hilo, Lara. AU - Radha, Raju K.. AU - Bunnapradist, Suphamai. AU - Czer, Lawrence. AU - Martin, Paul. AU - Jordan, Stanley. AU - Toyoda, Mieko. PY - 2006/5/1. Y1 - 2006/5/1. N2 - Background: BKV infection and nephropathy is a significant cause of allograft dysfunction in kidney transplantation. BKV viremia, rather than viruria, corresponds to BKV nephropathy. The prevalence of BKV viremia in non-renal solid organ transplants has not been systematically evaluated. Methods: We determined prevalence of BKV viremia in kidney, combined kidney-heart, kidney-liver, kidney-pancreas, kidney-heart-liver, and heart and liver transplant recipients using BKV-PCR. Results: Seven out of 173 (4%) kidney transplant recipients had BKV viremia, with BKV , 2 × 105 copies/mL in 6/7 and 1.9 × 103 in the remaining one patient. BKV ...

Chronic renal transplant rejection is a form of renal transplant rejection. It usually later following transplantation. Pathology Chronic rejection is defined as a gradual deterioration in graft function beginning at least 3 months after transp...

The Lorma Kidney Transplant Center provides personalized, holistic and best possible care to kidney transplant patients and their family. Our team is dedicated to make the entire kidney transplant process more convenient and less stressful for the patient. It has a multidisciplinary team composed of our best health care professionals who utilize evidence based practices and state-of-the-art diagnostic and surgical equipment.. Kidney Transplant: The best option for end-stage. Most often, kidney transplantation is the best treatment option for patients with chronic and end-stage renal disease. A kidney transplant is an operation that places a healthy kidney in the body. The transplanted kidney takes over the work of the two kidneys that failed and dialysis is no longer needed. Often,the new kidney will start making urine as soon as blood starts flowing through it. A successful kidney transplant affords a new beginning for ESRD patients because it offers enhanced quality and duration of ...

The ICAVL guidelines for transplant renal artery duplex ultrasound are similar to those for native arteries, with variations that include the need to examine the peri-transplant region with gray scale images, the arterial anastomosis with spectral Doppler waveforms and velocity measurements and the venous anastomosis with spectral Doppler waveforms. It should be noted that as external iliac artery stenosis can result in impaired blood flow to the transplanted kidney, this artery should also be interrogated as part of a complete examination.. Furthermore, it should be noted that transplant renal arteries have two characteristics that may cause elevated peak systolic velocity without stenosis. First, an end to side anastomosis may cause a local tortuosity and second, a transplant kidney tends to undergo hypertrophy and may be supplied by a higher than normal blood volume. Also, there is large normal variability of peak systolic velocity in transplant renal arteries.. Published peak systolic ...

BACKGROUND: Campath 1H is a depleting, humanized anti-CD52 monoclonal antibody that has now been used in 31 renal allograft recipients. The results have been very encouraging and are presented herein. METHODS: Campath 1H was administered, intravenously, in a dose of 20 mg, on day 0 and day 1 after renal transplant. Low-dose cyclosporine (Neoral) was then initiated at 72 hr after transplant. These patients were maintained on low-dose monotherapy with cyclosporine. RESULTS: At present, the mean follow-up is 21 months (range: 15-28 months). All but one patient are alive and 29 have intact functioning grafts. There have been six separate episodes of steroid-responsive rejection. One patient has had a recurrence of her original disease. Two patients have suffered from opportunistic infections, which responded to therapy. One patient has died secondary to ischemic cardiac failure. CONCLUSIONS: Campath 1H has resulted in acceptable outcomes in this group of renal allograft recipients. This novel therapy is of

Background: The prevalence of metabolic syndrome (MS) after renal transplantation has yet to be elucidated. In the present study, we investigated the prevalence of MS in Japanese renal transplant recipients.. Methods: A cross-sectional study was conducted to determine the prevalence of MS in 101 renal transplant recipients at Osaka City University Hospital. The prevalence of MS was determined using the National Cholesterol Education Program-Adult Treatment Panel III (NCEP-ATPIII) criteria (modified and original) and the International Diabetes Federation (IDF) criteria.. Results: Using the modified (Japanese) NCEP criteria, a total of 24 out of 101 patients (23.8%) had MS including 21 out of 64 male patients (32.8%) and three out of 37 female patients (8.1%). Using the modified (Asian) NCEP criteria, MS was diagnosed in 23 patients (22.8%); 19 male (29.7%) and four female (10.8%). Using the original NCEP criteria, MS was diagnosed in 15 patients (14.9%); 12 male (18.8%) and three female (8.1%). ...

PURPOSE: The development of a symptomatic lymphocele (SL) is a frequent postoperative surgical complication after kidney transplantation. It may lead to pain and discomfort and cause transplant malfunction or even secondary graft loss. A large cohort of renal recipients was investigated to identify the possible risk factors for SL. METHODS: All renal transplant patients of a single centre were retrospectively analysed for SL between January 2010 and December 2017. The SL group was compared to a control group from the same cohort. RESULTS: 45 out of 1003 transplanted patients developed an SL (incidence 4.5%), on average 50 days after kidney transplantation. SLs developed more in older patients, in those with a PD catheter and in ADKDP as primary diagnosis. Surgical predictors for SLs were venous anastomosis on the external iliac vein, concomitant PD catheter removal, perfusion defects, shorter operating time, splint , 7 days, double J stenting, discharge with drain, low initial drain production ...

Heres my already-submitted public comment to OPTN on their proposed policy for living kidney donor follow-up. The deadline for comment is December 23rd, so theres still time to compose and submit your own. The purpose of this missive is to respond to the proposed policy to establish minimum requirements for living kidney donor follow-up. Nearly 60 years after the first LKD transplant, there have been no randomized controlled trials to determine the testing required for the evaluation of living kidney donors(1). Transplant programs have little data to guide them in deciding which donors are unacceptable, or which characteristics are associated with kidney disease or poor psychosocial outcomes after donation(2) . Published studies are either single center, susceptible to selection bias and small sample sizes, or compare living donors the general public, an incorrect cohort(3) . Meanwhile, over the past 30 years, living kidney donors have gotten older, increased in pre-donation BMI, and decreased ...

TY - JOUR. T1 - Respiratory syncytial virus infections in pediatric renal transplant recipients. AU - Miller, Robert B.. AU - Chavers, Blanche M.. PY - 1996/4. Y1 - 1996/4. N2 - Immunocompromised patients are considered at increased risk from respiratory syncytial virus (RSV) infection. We examined the incidence and outcome of RSV infection in pediatric renal transplant (Tx) recipients on chronic immunosuppressive therapy. Of 173 recipients transplanted between November 1985 and April 1993, 5 (3%) developed RSV infection (age range 11-39 months). Initial immunosuppression included prednisone, azathioprine, cyclosporine, and polyclonal antibody therapy. Time from Tx to onset of RSV infection was 1 day to 7 months. Symptoms included rhinorrhea, cough, tachypnea, retractions, fever, wheezing, and abnormal chest X-ray. Treatment included bronchodilator therapy, bronchial drainage, ribavirin, and mist tent. Azathioprine was transiently withheld for leukopenia during treatment in 2 recipients. Three ...

The duration of warm ischemia time is associated with short and long-term kidney transplant function. A quick rise in graft temperature is reported during the vascular anastomosis. This study was initiated, to gain insight into the effect of graft temperature on short-term transplant function. From 2013 to 2015, data of living donor kidney transplant recipients was prospectively collected. At set intraoperative timepoints, the graft temperature was measured using a non-contact infrared thermometer. Primary endpoint was measured glomerular filtration rate (mGFR) at 3- and 6-months post-transplantation. Univariable and multivariable associations were identified using linear regression analyses. Multivariable analysis included models with donor, recipient and procedure characteristics. We evaluated 152 patients, 83 (55%) were male, mean ±SD age was 50.3 ±13.4 years and 79 (52%) were pre-emptively transplanted. In univariable analysis graft temperature, after 10 minutes of warm ischemia, was ...

TY - JOUR. T1 - Immunogenicity of the meningococcal polysaccharide conjugate vaccine in pediatric kidney transplant patients. AU - Nelson, Delphine R.. AU - Fadrowski, Jeffrey J.. AU - Neu, Alicia M. PY - 2018/3/20. Y1 - 2018/3/20. N2 - Background: Immunosuppressed kidney transplant patients may have suboptimal response to vaccinations. The aim of this study was to determine antibody response to a quadrivalent meningococcal conjugate vaccine (MenACWY-D) in adolescents with a kidney transplant. Methods: This was a prospective, single-center, cohort study. Adolescent patients (11-22 years old) with a functioning kidney transplant for at least 3 months and no previous meningococcal vaccination were eligible for enrollment. Antibody levels to all serogroups were measured before vaccination (baseline) and at 4 weeks and 1, 2 and 3 years after vaccination. Seropositivity was defined as a titer ≥ 1:8 at baseline, and seroconversion as a fourfold or greater increase in antibody titer from baseline at ...

BACKGROUND: In kidney transplant recipients, persistent hyperparathyroidism leads to hypercalcemia and increased urinary phosphorus excretion. The calcimimetic drug cinacalcet effectively decreases parathyroid hormone (PTH) levels and corrects hypercalcemia in these patients. The purpose of the present study is to examine the effect of cinacalcet treatment on determinants of renal phosphorus reabsorption under steady-state conditions. STUDY DESIGN: Open-label prospective uncontrolled trial. SETTING & PARTICIPANTS: 10 stable kidney transplant recipients with persistent hyperparathyroidism. INTERVENTION: Cinacalcet, 30 and 60 mg/d, for 2 weeks. OUTCOMES & MEASURES: Changes in urinary phosphorus excretion in timed urine samples, intact and carboxy-terminal (C-term) fibroblast growth factor 23 (FGF-23), intact PTH, venous pH, and bicarbonate values at defined intervals over 24 hours. RESULTS: Cinacalcet decreased renal phosphorus excretion in the first 8 hours by 30% to 40%, but not from 8 to 24 ...

Bazerbachi, F., Selzner, M., Boehnert, M.U., Marquez, M.A., Norgate, A., McGilvray, I.D., Schiff, J. and Cattral, M.S., 2011. Thymoglobulin versus basiliximab induction therapy for simultaneous kidney-pancreas transplantation: impact on rejection, graft function, and long-term outcome. Transplantation, 92(9), pp.1039-1043.. Chen, G., Gu, J., Qiu, J., Wang, C., Fei, J., Deng, S., Li, J., Huang, G., Fu, Q. and Chen, L., 2013. Efficacy and safety of thymoglobulin and basiliximab in kidney transplant patients at high risk for acute rejection and delayed graft function. Exp Clin Transplant, 11(4), pp.310-314.. Deeks, E.D. and Keating, G.M., 2009. Rabbit Antithymocyte Globulin (Thymoglobulin®). Drugs, 69(11), pp.1483-1512.. Favi, E., Gargiulo, A., Spagnoletti, G., Salerno, M.P., Silvestrini, N., Valente, I. and Citterio, F., 2010, May. Induction with basiliximab plus thymoglobulin is effective and safe in old-for-old renal transplantation: six-month results of a prospective clinical study. In ...

Living kidney transplantation comprises the majority of kidney transplantations in Japan. Living kidney donors should be assured of their own health. Therefore, Japanese guidelines define the criterion of kidney function for living donors. Glomerular filtration rates (GFR) ≥ 70 mL/min/1.73 m2 are required for marginal donors. The guidelines require that GFRs of donors be measured by the inulin (In) clearance method (CIn) or the radioisotope method, but these methods can be substituted with the creatinine (Cr) clearance method (CCr). Methods for estimating kidney function are susceptible to error, and decision-making regarding donor eligibility could be affected by the estimation method used. We investigated the adequacy of decision-making based on kidney function estimation methods used in Japanese living kidney donor candidates by comparing CCr or estimated GFR (eGFR), calculated by several equations, and CIn as measured GFR (mGFR). In total, 210 people, including 36 actual kidney donor candidates,

Background - Preemptive kidney transplants result in better outcomes and patient experiences than transplantation after dialysis onset. It is unknown how often a person initiates maintenance dialysis prior to living kidney donor transplantation when their donor candidate evaluation is well underway.. Methods - Using healthcare databases, we retrospectively studied 478 living donor kidney transplants from 2004-2014 across 5 transplant centres in Ontario, Canada where the recipients were not receiving dialysis when their donors evaluation was well underway. We also explored some factors associated with a higher likelihood of dialysis initiation before transplant.. Results - A total 167/478 (35%) persons with kidney failure initiated dialysis a median 9.7 (25th-75th percentile 5.4-18.7) months after their donor candidate began their evaluation, and received dialysis for a median 8.8 (3.6-16.9) months before kidney transplantation. The total cohorts dialysis cost was $8.1 million and 44/167 (26%) ...

ABO-incompatible kidney transplantation has been successfully utilised in a deceased donor and living donor kidney transplantation to improve organ utilisation and decrease waiting times. We describe a case of a successful, unanticipated ABO-incompatible donation after cardiac death (DCD) kidney transplant in a patient who had a previous ABOi haematopoietic stem cell transplant (HSCT) and had reverted to his original blood group B, after matching as a blood group A recipient with a blood group A donor. The recipient was unsensitized with a cPRA which was 0% and no donor-specific antibodies and zero HLA mismatch. An urgent anti-A titre was 1 : 2. Given the low antibody titres, we proceeded to transplantation. The patient developed delayed graft function and required dialysis on postoperative day 1 and day 2. The creatinine fell spontaneously on day 5, with progressively increased urine output and stable graft function on discharge at day 6. Anti-A titres were 1 : 1 on

Primary cilia are sensory organelles which co-ordinate several developmental/repair pathways including hedgehog signalling. Studies of human renal allografts suffering acute tubular necrosis have shown that length of primary cilia borne by epithelial cells doubles throughout the nephron and collecting duct, and then normalises as renal function returns. Conversely the loss of primary cilia has been reported in chronic allograft rejection and linked to defective hedgehog signalling. We investigated the fate of primary cilia in renal allografts suffering acute rejection. Here we observed that in renal allografts undergoing acute rejection, primary cilia were retained, with their length increasing 1 week after transplantation and remaining elevated. We used a mouse model of acute renal injury to demonstrate that elongated renal primary cilia in the injured renal tubule show evidence of smoothened accumulation, a biomarker for activation of hedgehog signalling. We conclude that primary cilium-mediated

OBJECTIVES: Primary cilia are sensory organelles which co-ordinate several developmental/repair pathways including hedgehog signalling. Studies of human renal allografts suffering acute tubular necrosis have shown that length of primary cilia borne by epithelial cells doubles throughout the nephron and collecting duct, and then normalises as renal function returns. Conversely the loss of primary cilia has been reported in chronic allograft rejection and linked to defective hedgehog signalling. We investigated the fate of primary cilia in renal allografts suffering acute rejection. RESULTS: Here we observed that in renal allografts undergoing acute rejection, primary cilia were retained, with their length increasing 1 week after transplantation and remaining elevated. We used a mouse model of acute renal injury to demonstrate that elongated renal primary cilia in the injured renal tubule show evidence of smoothened accumulation, a biomarker for activation of hedgehog signalling. We conclude that primary

TY - JOUR. T1 - Nitric oxide production and nitric oxide synthase expression in acute human renal allograft rejection. AU - Albrecht, EWJA. AU - van Goor, H. AU - Tiebosch, ATMG. AU - Moshage, H. AU - Tegzess, Adam. AU - Stegeman, CA. PY - 2000/12/15. Y1 - 2000/12/15. N2 - Background Nitric oxide (NO) is produced by nitric oxide synthases (NOS), which are either constitutively expressed in the kidney or inducible, in resident and infiltrating cells during inflammation and allograft rejection. NO is rapidly degraded to the stable end products nitrite and nitrate, which can be measured in serum and urine, and may serve as noninvasive markers of kidney allograft rejection.Methods. Total nitrite and nitrate levels (NOx) were measured in serum and urine thrice meekly after an overnight fast in 18 consecutive patients following renal cadaveric transplantation. Inducible NOS (iNOS) and endothelial NOS (eNOS) expression was immunochemically determined in renal biopsy specimens with or without acute ...

TY - JOUR. T1 - The development of a laparoscopic donor nephrectomy program in a de novo renal transplant program. T2 - Evolution of technique and results in over 200 cases.. AU - Lallas, Costas D.. AU - Castle, Erik P.. AU - Schlinkert, Richard T.. AU - Andrews, Paul E.. PY - 2006/1/1. Y1 - 2006/1/1. N2 - BACKGROUND AND OBJECTIVES: In 1999, our institution began a kidney transplant program with collaboration between the departments of General Surgery/Transplantation and Urology. From the onset, donor nephrectomies were performed laparoscopically and are currently the domain of Urology, which had no prior laparoscopic experience before this undertaking. We reviewed our experience. METHODS: A database of our experience was kept prospectively from June 1999 to November 2004. Records of both donors and recipients were reviewed. Special attention was directed toward our changes in technique and their relationship to outcomes, with emphasis on graft extraction and overall complication rates. RESULTS: ...

Background. In the past 20 years, BK virus has emerged as a cause of early graft dysfunction after kidney transplantation. In the setting of chronic immunosuppression (IS), the latent virus can reactivate, leading to BK viremia (10-20%) and in 1-10% of kidney transplant recipients to BK virus nephropathy (BKVN). The early detection of BK viremia by serum DNA PCR screening allows prompt but controlled reduction of IS, which, despite numerous attempts to find specific antiviral agents, remains the mainstay therapy. So far, besides potent IS, no risk factor has been consistently associated with BK viremia/BKVN. The use of a ureteral stent at the time of transplantation to protect the ureterovesical anastomosis has been described as a potential trigger. In this study, we aimed at defining the incidence and kinetics of BK viremia in our local cohort of kidney transplant recipients, and analysed potential predictors of BK viremia/BKVN, including ureteral stents. Methods. We performed a singl

TY - JOUR. T1 - Relationship between inpatient hyperglycemia and insulin treatment after kidney transplantation and future new onset diabetes mellitus. AU - Chakkera, Harini A.. AU - Knowler, William C.. AU - Devarapalli, Yugandhara. AU - Weil, E. Jennifer. AU - Heilman, Raymond L.. AU - Dueck, Amylou. AU - Mulligan, David C.. AU - Reddy, Kunam S.. AU - Moss, Adyr A.. AU - Mekeel, Kristin L.. AU - Mazur, Marek J.. AU - Hamawi, Khaled. AU - Castro, Janna C.. AU - Cook, Curtiss B.. N1 - Copyright: Copyright 2011 Elsevier B.V., All rights reserved.. PY - 2010/9/1. Y1 - 2010/9/1. N2 - Background and objectives: Approximately two-thirds of kidney transplant recipients with no previous history of diabetes experience inpatient hyperglycemia immediately after kidney transplant surgery; whether inpatient hyperglycemia predicts future new onset diabetes after transplant (NODAT) is not established. Design, setting, participants, & measurements: A retrospective study was conducted to determine the risk ...

INTRODUCTION Few studies are available regarding the various promoting factors of H. pylori infection in kidney disease patients especially renal transplant individuals. OBJECTIVES This study was therefore conducted to examine the association of serum magnesium with H. pylori infection among kidney transplant patients. This cross-sectional investigation was conducted on a group of stable kidney transplant patients. Peripheral venous blood samples were collected for biochemical analysis after an overnight fast, Also urea breath test (UBT) was conducted for patients. PATIENTS AND METHODS A total of 50 cases was enrolled to the study. Mean serum magnesium value of the patients was 1.98 ± 0.62 mg/dl. Serum magnesium level in positive H. pylori patients was more than negative H. pylori patients (p=0.0005). In this study population, there was no significant difference in serum intact PTH, calcium, alkaline phosphatase, albumin levels and body mass index (BMI) between males and females or H. pylori ...

TY - JOUR. T1 - Quantifying the risk of incompatible kidney transplantation. T2 - A multicenter study. AU - Orandi, B. J.. AU - Garonzik-Wang, J. M.. AU - Massie, A. B.. AU - Zachary, A. A.. AU - Montgomery, J. R.. AU - Van Arendonk, K. J.. AU - Stegall, M. D.. AU - Jordan, S. C.. AU - Oberholzer, J.. AU - Dunn, T. B.. AU - Ratner, L. E.. AU - Kapur, S.. AU - Pelletier, R. P.. AU - Roberts, J. P.. AU - Melcher, M. L.. AU - Singh, P.. AU - Sudan, D. L.. AU - Posner, M. P.. AU - El-Amm, J. M.. AU - Shapiro, R.. AU - Cooper, M.. AU - Lipkowitz, G. S.. AU - Rees, M. A.. AU - Marsh, C. L.. AU - Sankari, B. R.. AU - Gerber, D. A.. AU - Nelson, P. W.. AU - Wellen, J.. AU - Bozorgzadeh, A.. AU - Gaber, A. O.. AU - Montgomery, R. A.. AU - Segev, D. L.. N1 - Copyright: Copyright 2014 Elsevier B.V., All rights reserved.. PY - 2014/7. Y1 - 2014/7. N2 - Incompatible live donor kidney transplantation (ILDKT) offers a survival advantage over dialysis to patients with anti-HLA donor-specific antibody (DSA). ...

Living donation is one type of kidney transplant. Through this process, a living person with two healthy kidneys donates one kidney to a relative or close friend with kidney failure. It is generally possible-and safe-to donate a kidney and still have normal kidney function. Studies have shown that donation does not cause harm to the donors remaining kidney and that people with one kidney have the same life expectancy as people with two kidneys.. For the kidney recipient, receiving a living donor transplant has a number of advantages over a deceased donor transplant. For one, there is still a great shortage of deceased donor kidneys creating a need for a waiting list - that is not necessary with living donation. Furthermore, living donation provides the ability to better plan for surgery. Statistically, living donor kidneys are less likely to reject and are more successful.. Donating a kidney can be one of the most rewarding experiences of a lifetime. However, the possibility of kidney donation ...

TY - JOUR. T1 - Results of repeat renal transplantation after graft loss from BK virus nephropathy. AU - Geetha, Duvuru. AU - Sozio, Stephen M.. AU - Ghanta, Mythili. AU - Josephson, Michelle. AU - Shapiro, Ron. AU - Dadhania, Darshana. AU - Hariharan, Sundaram. PY - 2011/10/15. Y1 - 2011/10/15. N2 - Background.: BK virus nephropathy (BKVN) is an important cause of renal graft loss in recent years. The aims of this study are to (1) describe the management of patients undergoing retransplantation after allograft loss in the setting of BKVN and (2) to identify risk factors for BK virus replication in the retransplant. Methods.: This retrospective study compiled data on adult patients undergoing repeat transplantation after previous loss of allograft to BKVN from six US centers. Clinical, laboratory, and histopathologic data for both the transplant that failed because of BKVN and the retransplant were abstracted and reviewed. Results.: A total of 31 patients underwent retransplantation after a ...

TY - JOUR. T1 - Detection of medical errors in kidney transplantation. T2 - A pilot study comparing proactive clinician debriefings to a hospital-wide incident reporting system. AU - McElroy, Lisa M.. AU - Daud, Amna. AU - Lapin, Brittany. AU - Ross, Olivia. AU - Woods, Donna M.. AU - Skaro, Anton I.. AU - Holl, Jane L.. AU - Ladner, Daniela P.. N1 - Publisher Copyright: © 2014 Elsevier Inc. All rights reserved. Copyright: Copyright 2014 Elsevier B.V., All rights reserved.. PY - 2014/11/1. Y1 - 2014/11/1. N2 - Background Rates of medical errors and adverse events remain high for patients who undergo kidney transplantation; they are particularly vulnerable because of the complexity of their disease and the kidney transplantation procedure. Although institutional incident-reporting systems are used in hospitals around the country, they often fail to capture a substantial proportion of medical errors. The goal of this study was to assess the ability of a proactive, web-based clinician safety ...

Sirs,. We read with great interest the study by Neuhaus et al. reporting on live kidney donors (that had donated by open nephrectomy) and their high degree of satisfaction with the predonation decision-making process, along with improved postdonation relationships with their partners and the recipient children [1].. One question that this valuable and insightful study was unable to answer was whether the recent introduction of the less invasive laparoscopic technique (which has rapidly become the standard of care) [2, 3] has had any additional effects on the decision-making process and postoperative family dynamics and quality of life of those donating a kidney to a pediatric recipient. Interestingly, in adult-to-adult live donor kidney transplantation, several studies have demonstrated that laparoscopic live donor nephrectomy does not only significantly decrease postoperative morbidity [4], but may therefore also have contributed to the steady increase of live donor kidney transplants... ...

In this study we developed a high-throughput DNA sequencing assay to measure circulating B cell repertoires in highly HLA-sensitized kidney transplant candidates undergoing desensitization therapy to lower HLA antibodies and enable transplantation. We hypothesized that measuring circulating B cell repertoires could help identify which candidates will respond to desensitization therapy. cPRA is a measure of sensitization based on pre-existing HLA antibody specificities and strength in combination with the frequency of HLA antigens in the donor population. Since cPRA also represents the probability of receiving a compatible transplant, this measurement is often used to determine success of desensitization therapy [23, 31]. We assessed response to therapy as a clinically meaningful and durable decrease in cPRA of 5% points or greater based on literature and transplant outcomes data [2, 26].. We first compared B cell repertoires in pre-treatment samples in three groups: sensitized candidates who ...

Title:New-onset Diabetes Mellitus: Predictive Factors and Impact on the Outcome of Patients Undergoing Liver Transplantation. VOLUME: 9 ISSUE: 1. Author(s):Gerardo Sarno, Rucha J. Mehta, Rodolfo Guardado-Mendoza, Lilia M. Jimenez-Ceja, Paride De Rosa and Giovanna Muscogiuri. Affiliation:Department of General Surgery and Transplantation Unit, San Giovanni di Dio e Ruggi DAragona University Hospital, Scuola Medica Salernitana, Via San Leonardo, I- 84131, Salerno (Italy).. Keywords:Liver transplantation, metabolic syndrome, new-onset diabetes mellitus, HCV, immunosuppressive therapy, nonalcoholic steatohepatitis, insulin resistance, liver surgery. Abstract:Liver transplantation (LT) for hepatocellular carcinoma (HCC) is the treatment of choice for patients with tumor characteristics within the Milan criteria associated with Child B or C cirrhosis. LT provides the best cure for both the tumor and the cirrhosis. There have been several emerging reports that new-onset diabetes mellitus (NODM) after ...

During the last 12 years 400 renal allograft biopsies have been performed at this institution to facilitate the differential diagnosis of post-transplant renal dysfunction. Of these cases significant urological complications occurred in 3. In 1 patient a caliceal cutaneous fistula developed after an open surgical biopsy, which required nephrostomy drainage for 6 months. The other 2 patients had needle biopsies and, subsequently, anuria occurred from ureteral blood clots. The problem resolved spontaneously after 23 hours in 1 patient and after 30 hours in the other. The complications in these 3 patients are believed to have resulted from a deeper biopsy and consequent damage to the medullary vasculature and the pelviocaliceal collecting system. Because of these and other potential problems, renal transplant biopsies should be performed by experienced staff, after careful consideration of the risk/benefit ratio at each individual setting.

Following kidney transplants, patients notice very little survivability differences when using home dialysis instead of hospital dialysis, doctors explain.

The symptoms of end stage renal failure present in every system, such as the nervous system, digestive system and so on. End stage renal failure is the later symptom of all kinds of Kidney Disease. The occurrence of these symptoms seriously threatens patients physical and psychological health. What are symptoms of early End stage renal failure? ...

In potential living kidney donors, glomerular filtration rate (GFR) is often evaluated from the creatinine clearance (Ccr) or is predicted using formulas based on serum creatinine (SCr) or cystatin C (SCys) concentration. Ultrasonography is used to evaluate renal structure and dimensions. The objective of the present study was to evaluate the possibility of estimation of GFR from echographic renal dimensions in 66 potential live kidney donors (46 women and 20 men; age range, 25-73 years). The GFR was measured as the renal clearance of technetium 99m diethylenetriamine pentaacetic acid. The GFR was also estimated from the SCr concentration using the Cockcroft-Gault (CG-Ccr) and Modification of Diet in Renal Disease (MDRD-GFR) formulas and from SCys (Cys-GFR). Renal diameters were measured using conventional gray-scale renal ultrasound to estimate total and parenchymal renal volume using ellipsoid formulas. The GFR was predicted from renal dimensions on the basis of their relationship to measured ...

BackgroundThe ABO blood group system is clinically important in kidney transplantation, but ABO genotyping fails to attract sufficient attention in some countries and regions. We identified one case of early graft dysfunction due to an ABO genotype mismatch. Here, we performed ABO genotyping in blood samples, analyzed grouping discrepancies, and investigated the weak A subgroup frequency in kidney transplantation candidates.MethodsBlood samples from 302 uremic patients with grouping discrepancies and 356 uremic patients with type A blood were analyzed using standard serologic serotyping techniques. The ABO genotypes and alleles were analyzed by polymerase chain reaction sequence-specific primer (PCR-SSP) and sequence-based typing (PCR-SBT).ResultsAll 302 uremic patients with grouping discrepancies carried weak ABO subgroup alleles and 77.48% carried irregular ABO antibodies. The discrepancy rate between serotyping and genotyping was 42.38%, and the mismatching rate of donor selection according to

The placebo-controlled renal transplant study generally showed fewer adverse events occurring in ≥ 20% of patients. In addition, those that occurred were not only qualitatively similar to the azathioprine-controlled renal transplant studies, but also occurred at lower rates, particularly for infection, leukopenia, hypertension, diarrhea and respiratory infection.. The above data demonstrate that in three controlled trials for prevention of renal rejection, patients receiving 2 g/day of mycophenolate mofetil had an overall better safety profile than did patients receiving 3 g/day of mycophenolate mofetil.. The above data demonstrate that the types of adverse events observed in multicenter controlled trials in renal, cardiac, and hepatic transplant patients are qualitatively similar except for those that are unique to the specific organ involved.. Sepsis, which was generally CMV viremia, was slightly more common in renal transplant patients treated with mycophenolate mofetil compared to patients ...

The above information should be taken into account when considering conversion from calcineurin inhibitors to Rapamune in stable renal transplant patients due to the lack of evidence showing that renal function improves following conversion, and the finding of a greater increment in urinary protein excretion, and an increased incidence of treatment-emergent nephrotic range proteinuria following conversion to Rapamune. This was particularly true among patients with existing abnormal urinary protein excretion prior to conversion.. In an open-label, randomized, comparative, multicenter study where kidney transplant patients were either converted from tacrolimus to sirolimus 3 to 5 months post-transplant (sirolimus group) or remained on tacrolimus, there was no significant difference in renal function at 2 years post-transplant. Overall, 44/131 (33.6%) discontinued treatment in the sirolimus group versus 12/123 (9.8%) in the tacrolimus group. More patients reported adverse events 130/131 (99.2%) ...

We describe a caucasian 17-year old male, transplanted at three years of age because of ESRD due to congenital nephrotic syndrome (Finnish type), who lost his first graft due to chronic allograft nephropathy. While on the waiting list, he presented a progressive rise in Panel Reactive Antibodies levels (PRA 99.61%). The patient received a desensitization protocol based on plasmapheresis (PP), immunoglobulins and Rituximab, with minor response (post desensitization PRA 75%). He was enrolled in a National Protocol for organs allocation to immunized patients and received his second non-living HLA-compatible kidney transplant at the age of 16. He had prompt function of his allograft. On postoperative day 30 he developed a biopsy-proven antibody-mediated rejection (AMR) [Figure 1].. Post-transplant immunological monitoring showed donor-specific anti-DQ5 antibodies (DSA) that were already present at the time of transplantation. The patient received three methylprednisolone pulses and 45 PP sessions, ...

On analysis of 15,523 kidney transplant recipients, blood group O was not associated with patient survival (hazard ratio (HR) 0.96, 95% confidence interval (CI) 0.89-1.04) nor death censored graft survival (HR 0.97, 95% CI 0.89-1.05) compared to non-blood group O recipients. Competing risks analyses showed an increased risk of cancer-related mortality in blood group O recipients on univariate analyses (HR 1.18, 95% CI 1.01-1.37) however, this became insignificant on multivariate analyses. On secondary analyses, recipient blood group AB (4.11% participants) was associated with inferior death censored graft survival compared to those with blood group O (HR 1.24, 95% CI 1.02-1.50). Although recipient ABO blood groups were not associated with patient nor graft survival, differences in cause-specific mortality between individual blood groups cannot be excluded based on current analyses ...

Regenerative Medicine: applying tissue engineering, stem cell therapy, medical devices and other techniques to repair damaged or diseased tissues and organs. The University of Pittsburgh School of Medicine and UPMC Health System have established the McGowan Institute for Regenerative Medicine which serves as a single base of operations for the universitys leading scientists and clinical faculty working to develop regenerative medicine therapies. The McGowan Institute enables cutting-edge basic and clinical research to be performed across disciplines allowing rapid development of therapies and swift evaluation in a clinical setting.

The health of all populations will benefit from a comprehensive response to diseases contributing to end-stage organ failure, from prevention to access to effective organ transplantation programmes made possible by a sufficient supply of donor organs. There is also a strong economic imperative to improve rates of transplantation and therefore organ donation: kidney transplantation is less costly to provide than dialysis, and therefore, maximizing rates of kidney transplantation would significantly reduce overall expenditure on renal replacement therapies. Kidney transplantation also results in better survival and quality of life outcomes and enables greater productivity and community participation. The perception of organ transplantation as an expensive and luxury clinical practice is invalid; rather it is cost effective, mainstream, and a cardinal feature of comprehensive health services. Beyond the unmistakable medical benefits to patients affected by end-stage organ failure, organ ...

TY - JOUR. T1 - Ontogeny of a surgical technique. T2 - Robotic kidney transplantation with regional hypothermia. AU - Sood, Akshay. AU - McCulloch, Peter. AU - Dahm, Philipp. AU - Ahlawat, Rajesh. AU - Jeong, Wooju. AU - Bhandari, Mahendra. AU - Menon, Mani. N1 - Publisher Copyright: © 2015 IJS Publishing Group Limited. Copyright: Copyright 2017 Elsevier B.V., All rights reserved.. PY - 2016/1/1. Y1 - 2016/1/1. N2 - Introduction: Innovation is a hallmark of surgical practice. It is generally accepted that a new procedure will undergo technical changes during its evolution; however, quantitative accounts of the process are limited. Methods: Multiple groups, including our own, have recently described a minimally-invasive approach to conventional kidney transplantation (KT) operation. Unique to our experience is a structured development of the technique within the confines of a safe surgical innovation framework - the IDEAL framework (idea, development, exploration, assessment, long-term ...

Australian Medicines Handbook section 14.5.3 Anti-thymocyte globulin is indicated for the prophylaxis of renal graft rejection as well as the treatment of steroid-resistant renal transplant rejection. Kidney transplantation is the treatment of choice for most patients with end-stage renal disease. However, 15-35% of transplant recipients will experience one episode of acute rejection in the first year. Giving antibody to deplete thymocytes (T cells) is one way to suppress the immune system to prevent or reverse graft rejection. Anti-thymocyte globulin is a polyclonal antibody against human T cells. It is a gamma immunoglobulin produced by immunising rabbits. As well as depleting T cells in the circulation, anti-thymocyte globulin is also thought to reduce T cell proliferation, homing and cytotoxic effects within the body. Depletion of T cells occurs within a day of starting intravenous treatment. This immunoglobulin has been compared to other treatments in renal transplant patients who are also ...

Richmond, VA 23219. Re: Concepts in Kidney Allocation. March 27, 2011. I thank the Kidney Transplantation Committee for the opportunity to comment on, Concepts in Kidney Allocation. I would like to focus on provisions made for prior donors who progress to kidney failure.. Mr. Ron Herrick, the first living kidney donor, died in December of 2010 while on dialysis. Prior to this he had suffered from cardiovascular disease for over a decade. This news is alarming because of what it may portend for aging kidney donors. Although transplantation is often described as miracle for the recipient, rarely is it mentioned, even to kidney donors, that: Every kidney donor will experience a decrease in the kidney function compared to pre- donation. The amount will depend upon the potential donors age and history. The anticipated change in their individual kidney function is to be discussed with each donor…potential for organ failure and the need for a future organ transplant for the donor…potential for ...

Percutaneous needle core biopsy may be the definitive procedure where important diagnostic and prognostic information in acute and persistent renal allograft dysfunction is normally obtained. the promise of improving diagnostic precision and developing fresh, processed molecular pathways for restorative treatment will also be offered. Intro Renal biopsy remains the platinum standard by which essential diagnostic and prognostic info is definitely acquired after kidney transplantation.1,2 Biopsy methodologies have been devised to assess the acceptability of an organ before transplantation and to assess and forecast renal allograft overall performance after implantation. Renal transplant biopsy samples are analyzed from the same traditional and modern techniques as are used to assess samples from native kidneys (Package 1). With this Review, we describe the practical part D-106669 of renal biopsy in the management of renal allograft recipients and spotlight the changes that take place in renal ...

TY - JOUR. T1 - Ex vivo application of carbon monoxide in UW solution prevents transplant-induced renal ischemia/reperfusion injury in pigs. AU - Yoshida, J.. AU - Ozaki, K. S.. AU - Nalesnik, M. A.. AU - Ueki, S.. AU - Castillo-Rama, M.. AU - Faleo, G.. AU - Ezzelarab, M.. AU - Nakao, A.. AU - Ekser, B.. AU - Echeverri, G. J.. AU - Ross, M. A.. AU - Stolz, D. B.. AU - Murase, N.. PY - 2010/4. Y1 - 2010/4. N2 - I/R injury is a major deleterious factor of successful kidney transplantation (KTx). Carbon monoxide (CO) is an endogenous gaseous regulatory molecule, and exogenously delivered CO in low concentrations provides potent cytoprotection. This study evaluated efficacies of CO exposure to excised kidney grafts to inhibit I/R injury in the pig KTx model. Porcine kidneys were stored for 48 h in control UW or UW supplemented with CO (CO-UW) and autotransplanted in a 14-day follow-up study. In the control UW group, animal survival was 80% (4/5) with peak serum creatinine levels of 12.0 ± 5.1 ...

BACKGROUND: Bacteriuria is common post-transplant. However, most studies are in adults with a short follow-up. We have assessed the incidence of bacteriuria, predisposing causes and its effect on short and long-term graft function in children. METHODS: The notes of 142 children (67% male) who received 168 kidney transplants (138 cadaveric) between 1987 and 1994 were studied. The mean age at transplantation was 9.0 +/- 4.5 years, and 32 children were transplanted pre-emptively. Diagnoses reflected those found in any childrens renal failure programme. RESULTS: Two hundred and thirty one episodes of bacteriuria were detected in 66 patients patients (46%): a rate of one episode per 23 patient months of follow-up. Fifty two percent were during the first year, and 29% of these during the first 4 weeks post-transplant. Forty two children (28%) had recurrences. The incidence was not affected by sex, vesico-ureteric reflux into native kidneys, donor source, circumcision in boys, dialysis pre-transplant ...

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In addition to an improvement in survival post-transplantation, the studies of Kobashigawa et al. (77) and Wenke et al. (78) provide evidence for an immunomodulatory effect of statins. Pravastatin significantly decreased the rate of haemodynamically important rejection episodes (P, 0·01), associated with improved survival (77). This finding was reproduced in a small pilot study in renal transplant recipients, in whom pravastatin therapy also significantly reduced the incidence of acute rejection episodes (80).. The mechanism by which statins may interfere with the aggressive immunologically mediated process underlying allograft rejection remains unclear. One possible mechanism involves an indirect effect on the pharmacokinetics of cyclosporin. As this agent is lipophilic it is transported in the blood in LDL and HDL cores. Cyclosporin binding to lipoproteins accounts for approximately 35% of whole blood levels, thus any change in LDL-cholesterol may interfere with the removal of cyclosporin ...

As a Nephrologist and Kidney Transplant Surgeon in Delhi, his area of expertise includes hemodialysis, peritoneal dialysis, hemofiltration, hemodiafiltration, renal transplantation, Preemptive Kidney Transplant, Highly Antigenic Kidney Transplant, Re-Transplant, Transplantation, Severe metabolic acidosis, Life threatening hyperkalemia, Bleeding diathesis due to uremia, Pericarditis, Management of obstructive kidney diseases, preventing stone disease recurrence, Creation of AV fistula, Central line and perma cath for long term hemodialysis, Care of Vascular access, Kidney Stone Removal, ESWL, PCNL or Ureteroscopy ...

Nevadas first kidney transplant took place at UMC on Christmas Day 1989. Since then many patients have received the gift of life through the transplant program.. After transplantation many people enjoy a better quality of life by being able to return to work, school, hobbies, and family activities. To date, over 1000 people have received a kidney transplant at UMC.. Because of advances in surgical techniques, post-transplant medications and careful follow-up, organ transplantation is now the most successful treatment choice for people with different types of kidney diseases. UMC kidney transplant patients now enjoy a success rate of greater than 97% at one year.. Only an organized team of specialists can give you a comprehensive view of the entire transplant process. As such, the UMC multidisciplinary transplant team is comprised of physicians, nurses, pharmacists, dieticians, social workers, financial counselors, and Living Donor coordinators who will happily assist you with all your ...