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1.
T. Inoue M. Saito S. Narita K. Numakura H. Tsuruta A. Maeno N. Tsuchiya S. Satoh T. Habuchi 《Transplantation proceedings》2017,49(8):1786-1790
Objectives
Using a strategy of placing a surgical drain after kidney transplantation, the duration of a lymphatic fluid leakage and prevalence of a symptomatic lymphocele were retrospectively analyzed. The risk factors for persistent lymphatic fluid leakage or asymptomatic lymphocele were evaluated using multivariate analysis to estimate the origin of the lymphatic fluid leakage.Materials and methods
Patients with persistent lymphatic fluid leakage and symptomatic lymphocele were defined as those with lymphatic fluid drainage >50 mL for more than 15 days and those who required a percutaneous drainage of the lymphocele, respectively.Results
Persistent lymphatic fluid leakage and symptomatic lymphocele were observed in 40 (16.4%) and 10 (4.1%) of a total of 244 patients, respectively. The maximum durations of lymphatic fluid drainage from the initial drain tube and the second drainage of the symptomatic lymphocele were 48 and 28 days, respectively. Anastomosis of the graft artery to the external iliac artery was an independent risk factor to predict persistent lymphatic fluid leakage or symptomatic lymphocele after kidney transplantation (odds = 2.597, P = .008).Conclusion
The findings of the study suggest that the lymphatic fluid originates from the recipient's iliac lymph trunk rather than from the graft kidney. 相似文献2.
W.Y. Park S. Han B.S. Choi C.W. Park C.W. Yang Y.-S. Kim J.I. Kim I.S. Moon B.H. Chung 《Transplantation proceedings》2017,49(5):1033-1037
Background
This study investigated the prevalence of osteoporosis and the risk factors for its progression in kidney transplant recipients (KTRs).Methods
Dual energy X-ray absorptiometry was used to prospectively measure changes in bone mineral density (BMD) before kidney transplantation (KT) and 1 year after transplantation in 207 individuals. We also analyzed the risk factors of osteoporosis progression during this period.Results
Prior to KT, the mean BMD score (T-score of the femur neck area) was ?2.1 ± 1.2, and the prevalence of osteoporosis was 41.5% (86/207). At 1 year post-transplantation, the mean BMD score significantly decreased to ?2.3 ± 1.1 (P < .001), and the prevalence of osteoporosis increased to 47.3% (98/207; P = .277). The BMD score worsened over the study period in 69.1% (143/207) of patients, improved in 24.1% (50/207), and showed no change in 6.8% (14/207). Minimal intact parathyroid hormone (iPTH) improvement after KT was found to be an independent risk factor of osteoporosis progression.Conclusions
This study demonstrates progressive loss of BMD after KT and sustained secondary hyperparathyroidism might influence the progression of osteoporosis. 相似文献3.
M. Kono J. Hasegawa S. Wakai A. Ishiwatari Y. Abe M. Endo T. Sakoma K. Miyake T. Tokumoto K. Tanabe H. Shirakawa 《Transplantation proceedings》2017,49(5):1183-1186
Background
Sarcoidosis is a chronic systemic disease that is characterized by the formation of noncaseating granuloma and whose etiology is unclear. It is unclear whether patients with sarcoidosis are suitable organ donors.Case
We treated a 56-year-old woman with pulmonary sarcoidosis who donated her kidney. She was previously in good health and was diagnosed with pulmonary sarcoidosis during her preoperative examination. Because she presented with no symptoms and was otherwise in good condition, donor nephrectomy was performed.Results
Baseline biopsy examination showed no evidence of sarcoidosis. One year after transplantation, both the donor and the recipient had not developed kidney dysfunction or recurrence of sarcoidosis.Conclusion
This is a rare case in which a patient with pulmonary sarcoidosis donated a kidney for transplantation, and both the recipient and the donor were clinically healthy. A patient with sarcoidosis and no kidney lesion can donate a living kidney, because transplantation appears to be safe for both the recipient and the donor. 相似文献4.
Background
In kidney transplant recipients (KTRs) with hepatitis B virus (HBV) infection, immunosuppression may increase viral replication with increased risk for liver disease progression and HBV-related kidney diseases, factors that could adversely influence graft and patient outcomes. We aimed to analyze the impact of different phases of HBV infection on the outcomes in KTRs.Methods
Using the Organ Procurement and Transplant Network/United Network for Organ Sharing database, we selected adult KTRs from 2001 to 2011 who received peri-operative antibody induction followed by calcineurin inhibitor/mycophenolate mofetil maintenance with/without steroid. The cohort was divided into 4 groups, based on the presence/absence of hepatitis B surface antigen (HBsAg) and core antibody (HBcAb) at the time of transplantation: group 1: HBsAg+/HBcAb? (acute infection); group 2: HBsAg+/HBcAb+ (developing immune response); group 3; HBsAg?/HBcAb+ (resolving infection); and group 4: HBsAg?/HBcAb? (HBV-naive). Graft and patient survivals were compared among the groups in a multivariate Cox model.Results
Adjusted overall graft (hazard ratio [HR], 0.97; 95% confidence interval [CI], 0.90–1.10; P = .58) and patient (HR, 0.95; 95% CI, 0.83–1.09; P = .52) survival rates were similar between groups 1 and 2, with inferior death-censored graft survival in group 1 (HR, 0.83; 95% CI, 0.71–0.98; P = .02). Adjusted over all graft (HR, 1.0; 95% CI, 0.90–1.00; P = .46) and patient (HR, 1.03; 95% CI, 0.90–1.10; P = .10) survival rates were similar between groups 3 and 4, and death-censored graft survival trended inferior in group 3 (HR, 0.97; 95% CI, 0.90–1.00; P = .05).Conclusions
Our analysis supports a practice of delaying kidney transplantation in HBV-infected patients until they develop an immune response and preferably until the infection is cleared. 相似文献5.
T. Piskin B. Unal K. Kutluturk I.O. Yildirim B. Berktas S.M. Dogan J. Yagmur E.I. Coskun I. Turkcuoglu A. Beytur M. Sanli Y.Z. Colak G. Otlu H. Taskapan I. Sahin Y. Tabel U. Kayabas K. Sarac H.I. Toprak 《Transplantation proceedings》2017,49(3):460-463
Background
Kidney transplantation is the best treatment method for end-stage renal disease. Technically, left kidney transplantation is easier than right kidney, and the complication rates in the right are higher than the left kidney. We performed 28 kidney transplantations from 14 deceased donors between November 2010 and May 2016. Our aim was to share our outcomes and experiences about these 28 patients.Methods
We performed 182 kidney transplantations between November 2010 and May 2016. Fifty-four kidney transplantations were performed from deceased donors. Thirty-two of these were performed from 16 of the same donors. These 32 recipients' data were collected and retrospectively analyzed. We excluded the transplantations from two same-donors to their four recipients in this study. The remaining 28 recipients were included in the study.Results
The left and right kidney recipients' numbers were equal (14:14). The left kidney:right kidney rate was 11:3 in the first kidney transplantation recipient group; in the second kidney transplantation recipient group, the rate was 3:11. The difference was statistically significant (P = .002). We found no statistical differences for sex, mean age, and body mass index of recipients, total ischemic time of grafts, hospitalization times, creatinine levels at discharge time, and current ratio of postoperative complications of recipients (P > .05).Conclusions
There were no differences in the left or the right kidneys or in the first and the second kidney transplantations during the long follow-up period. 相似文献6.
G. Ozturk Emiral B. Isıktekin Atalay H. Altunok M.E. Gokler M.F. Onsuz S. Metintas 《Transplantation proceedings》2017,49(2):260-266
Introduction
Knowledge has an important role in an individual's willingness to donate organs upon death. Knowledge enables clarification of false beliefs, which can increase willingness to consent to organ donation. The purpose of the study was to describe and examine the validity and reliability of the Organ-Tissue Donation and Transplantation Knowledge Scale (ODTKS).Methods
We performed a comprehensive literature review and chose 23 items for the scale according to specialists' recommendations. A total of 6 items were excluded from the scale. Finally, the scale consisted of 17 items and 2 subdimensions.Results
The study group consisted of 540 (267 [49.4%] male and 273 [50.6%] female) nonmedical staff members; 23.5% were primary school graduates, 47.6% were high school graduates, and 28.9% had university degrees or higher. The difficulty index and discrimination index of the overall scale were 22.41% to 54.07% and 0.23 to 0.46, respectively. Cronbach α coefficient was 0.88 overall. Retest reliability scores were significant (r = 0.87, P < .001).Conclusions
The total score of the ODTKS was significantly higher among university graduates compared with primary school graduates and among people willing to donate. The ODTKS therefore has adequate reliability and validity for evaluating Turkish adults' knowledge about organ tissue donation and transplantation. 相似文献7.
S.E. Dogan Z.K. Celebi S. Akturk S. Kutlay A. Tuzuner K. Keven S. Sengul 《Transplantation proceedings》2017,49(3):532-536
Background
BK virus is the cause of nephropathy, which can progress to graft loss after kidney transplantation. In this study, we aimed to investigate the prevalence and risk factors of BK viremia in patients with kidney transplantation at our center.Methods
This was a retrospective single-center study. We included recipients transplanted between 2010 and 2015. Patients were stratified according to BK virus DNA follow-up values into three groups (0–999 copies/mL, 1000–9999 copies/mL and ≥10,000 copies/mL). The parametric t test and the non-parametric χ2 test were used to detect differences between groups. Multivariate analysis was used to identify risk factors for BK viremia.Results
One hundred eighty-three patients were included in the study, with mean follow-up time of 33.6 ± 14.9 months. BK viremia prevalence was found 15.8% (n = 29), and time to detection of viremia was 7.6 months. Cadaveric transplantation and matching human leukocyte antigen (HLA) A24 and HLA B55 subgroups were found to be independent risk factors for BK viremia [odds ratio (OR), 3.65; 95% confidence interval (CI), 1.42–9.39; P < .001; OR, 4.94; 95% CI, 1.84–13.2; P < .001 and OR, 14.03; 95% CI, 1.07–183.5; P = .04, respectively]. Risk factors for BKV level ≥10,000 copies/mL cadaveric transplantation, male sex, and HLA A24 matching (OR, 4.53; 95% CI, 1.49–13.7; P < .001; OR, 3.47; 95% CI, 1.11–10.86; P = .03 and OR, 3.63; 95% CI, 1.08–12.1; P = .03, respectively).Conclusions
Patients should be followed more carefully for BK viremia who have cadaveric transplantation, are male, and have matching in certain HLA groups, which were independent risk factors in the present study. Our results are important to individualize screening methods and provide early diagnosis in our country. 相似文献8.
Background
Acute kidney injury (AKI) is a common complication in the early period of lung transplantation (LTx). We aimed to describe the incidence and perioperative risk factors associated with AKI following LTx.Methods
Clinical data of 30 patients who underwent LTx were retrospectively reviewed. Primary outcomes were development of AKI and patient mortality within 30 postoperative days. Postoperative AKI is determined based on creatinine criteria from Acute Kidney Injury Network (AKIN) classification. Secondary outcomes included the association between AKI and demographic and clinical parameters of patients and treatment modalities in the pre- and postoperative periods.Results
Of the 30 LTx recipients included, AKI occurred in 16 patients (53.4%) within the first 30 days. Length of intensive care unit (P = .06) and hospital stay (P = .008) and mechanical ventilation duration (P = .03) were significantly higher in patients with AKI compared with patients without AKI. Factors independently associated with AKI were intraoperative hypotension (odds ratio [OR] 0.500; 95% confidence interval [CI], 1.145 to 26.412, P = .02), longer duration of mechanical ventilation (OR 1.204; 95% CI 0.870 to 1.665, P = .03), and systemic infection (OR 8.067; 95% CI 1.538 to 42.318, P = .014) in the postoperative period. Short-term mortality was similar in patients with and patients without AKI.Conclusion
By the AKIN definition, AKI occurred in half of the patients following LTx. Several variables including intraoperative hypotension, longer duration of mechanical ventilation, and systemic infection in the postoperative period independently predict AKI in LTx recipients. 相似文献9.
Y. Itabashi Y. Ohashi M. Muramatsu T. Kawamura Y. Hyodo Y. Hamasaki S. Shishido K. Sakai T. Maemura M. Morita A. Aikawa 《Transplantation proceedings》2017,49(5):1068-1072
Background
Despite restoration of fertility after kidney transplantation, the benefit is limited in female kidney recipients. Our objective is to determine the reasons for this discrepancy.Methods
We evaluated 315 women who underwent kidney transplantation from 1983 to 2015 (a median of age at transplantation [10th–90th percentile] of 32 years [7–55 years]); 230 recipients between the ages of 15 to 49 years old as of March 2016 were observed.Results
We experienced 10 abortions and 21 live births from our 23 recipients and 2 abortions and 7 live births in 7 recipients from other transplant center. The live birth rate was 8.9 per 1000 female transplant recipients of childbearing age. Seven recipients received either treatments of artificial insemination or in vitro fertilization. Average age at pregnancy was 33.2 ± 3.2 years old, and the fertile period post-transplantation was longer in recipients with live births than those without live births (14.1 ± 7.1 vs 9.9 ± 7.3 years, P < .05). In 42.9% of recipients with live birth, pregnancy-induced hypertension was observed in the last trimester. The gestational age and the average birth weight were 32.8 ± 5.0 months and 2184 ± 632 g, respectively. During follow-up of 14.5 years, there was one case of graft loss, which is a rate of 2.5 per 1000 female recipients.Conclusion
Although pregnancy complications are often observed in kidney recipients, graft survival is less influenced by pregnancy. Importantly, kidney disease at childbearing age disrupts pregnancy even after kidney transplantation. 相似文献10.
D. Cucchiari J. Rovira D. Paredes P. Ventura-Aguiar A. Sanchez-Escuredo M. Solé R. Adalia F. Oppenheimer F. Diekmann I. Revuelta 《Transplantation proceedings》2017,49(10):2260-2264
Background
Systemic inflammation affects kidney function in a wide range of diseases. Even in kidney transplant recipients, higher levels of C-reactive protein (CRP) are invariably associated with both worse short- and long-term graft outcomes. However, little is known about systemic inflammation in kidney donors and, notably, brain death causes a strong systemic inflammatory response.Objective
To analyze the role of systemic inflammation of brain-dead donors on short-term kidney graft outcomes (ie, delayed graft function [DGF], defined as the need of dialysis during the first week after transplantation).Materials and methods
Retrospective analysis of clinical and biochemical characteristics of all brain-dead kidney donors generated in the Hospital Clínic of Barcelona in the 2006 to 2015 period (n = 194). Donors who were tested for CRP in the 24 hours before BD declaration were included (n = 97, 50% of initial population). Clinical and biochemical features of their respective recipients (n = 165) were analyzed, comparing recipients who developed DGF (n = 30) with recipients who did not (n = 135).Results
Donors whose recipients later developed DGF had much higher CRP values (10.58 [5.1-18.21] vs 4.81 [1.42-12.2] mg/dL, P = .025). Other characteristics associated with the development of DGF were renal biopsy score and recipient dialysis vintage (P = .025 and P = .002, respectively). In logistic regression analysis, PCR maintained significance in the non–expanded criteria donor (ECD) group (odds ratio [OR], 1.102; P = .027), but it lost significance in the ECD group (P = .67).Conclusions
Terminal donor CRP was associated with DGF in kidney transplant recipients and proved to be mostly significant in younger donors. 相似文献11.
12.
A. Ministro T. Ferreira L. Batista A. Santana N. Alves J. Guerra J. Fernandes e Fernandes 《Transplantation proceedings》2017,49(4):906-912
Background
Vascular complications after kidney transplantation may cause allograft loss. Here, we describe 2 patients with extrarenal mycotic pseudoaneurysm after kidney transplantation.Patients
Patient 1 was a 54-year-old man who developed pseudoaneurysm 60 days after transplantation, and patient 2 was a 48-year-old woman who was diagnosed with a pseudoaneurysm 5 months after transplantation.Results
Patient 1 had a deceased-donor kidney transplant with end-to-side external iliac arterial anastomosis that was reconstructed 8 days after transplantation owing to rupture and major bleeding. At 60 days after transplantation, he had high serum creatinine level and Doppler ultrasonography showed a pseudoaneurysm of the arterial graft anastomosis and postanastomotic renal artery stenosis. Treatment included surgical excision of the pseudoaneurysm, vascular reconstruction, and fluconazole, with mycologic culture of the resected pseudoaneurysm showing Candida albicans. Patient 2 developed nondisabling intermittent claudication at 5 months after kidney transplantation, with a pseudoaneurysm subsequently observed on Doppler ultrasonography and computerized tomographic angiography. Treatment included renal artery thrombectomy and common iliac bypass to the hilar donor renal artery with inverted ipsilateral long saphenous vein. Operative samples showed C albicans, and she was treated with fluconazole. Both patients had satisfactory outcomes, and both kidney allografts were preserved.Conclusions
Extrarenal mycotic pseudoaneurysms after kidney transplantation require a high index of suspicion for early diagnosis, and preservation of the kidney graft may be achieved with the use of surgical treatment and antifungal therapy. 相似文献13.
Background
Hyperparathyroidism is a common complication in chronic kidney disease and might persist in up to 25% of patients after transplantation. In this setting, vitamin D analogues further aggravate persistent hypercalcemia and cinacalcet has not been approved for these patients, some of whom will require parathyroidectomy to correct post-transplantation hyperparathyroidism.Objectives
In this single-center, retrospective study we aimed to analyze the long-term effect of parathyroidectomy on calcium, phosphorus, and parathyroid hormone (PTH) levels and its effect on allograft function in kidney transplantation patients submitted to parathyroidectomy.Patients and Methods
Fifteen patients underwent parathyroidectomy between January 2005 and January 2015; median age 54 years old; 8 (53.3%) were receiving cinacalcet at the time of surgery. Pre-parathyroidectomy median values of intact PTH, calcium, and phosphorus were, respectively, 262 pg/mL, 10.8 mg/dL, and 2.4 mg/dL. Surgery consisted of uniglandular parathyroidectomy in 5 (33.3%) patients, biglandular in 4 (26.7%), and subtotal in 6 (40%). There was no surgery-related mortality.Results
Compared with baseline, there was a decrease of PTH (262 pg/mL vs. 106 pg/mL, P = .001), calcium, and phosphorus levels (10.8 mg/dL vs. 10.4 mg/dL, P = .3; 2.4 vs. 2.9 mg/dL, P = .05) 1 year after surgery; with normalization of serum calcium at the end of follow-up (10.8 mg/dL vs. 9.4 mg/dL, P = .04). A decrease in estimated glomerular filtration rate occurred 1 month post-surgery (62.7 mL/m vs. 49.7 mL/m, P = .006) but returned to baseline 1 year after surgery (62.7 mL/m vs. 60.8 mL/m, P = .73).Conclusion
Parathyroidectomy appears to be a safe procedure and should be considered in kidney transplantation patients with persistent post-transplantation hyperparathyroidism. Although there was an acute estimated glomerular filtration rate decrease, we observed no long-term deterioration in allograft function. 相似文献14.
L. Giglio Canelhas de Abreu L. Proença Vieira T. Teixeira Gomes F. Bacal 《Transplantation proceedings》2017,49(4):874-877
Objective
The aim of this work was to verify the association between clinical and nutritional factors and mortality in the 1st 30 days after heart transplantation.Methods
This was a retrospective study of patients who underwent heart transplantation in a public hospital in Brazil from January 2013 to August 2015. The clinical and nutritional factors analyzed were: body mass index, body surface area, cachexia, infection, duration of orotracheal intubation, ejection fraction, mean pulmonary pressure, Interagency Registry for Mechanically Assisted Circulatory Support (INTERMACS) score, hemoglobin, and diabetes mellitus. The primary outcome was mortality in the 1st 30 days after heart transplantation, and secondary outcomes were infection, acute kidney insufficiency, and duration of orotracheal intubation. We performed chi-square test, unpaired t test, and logistic regression in the analyses. A P value of < .05 was considered to be significant.Results
The sample had 103 patients, of which 16 patients (15.53%) died within 30 days after heart transplantation. We observed a relationship between death and orotracheal intubation duration (P < .01), postoperative creatinine (P < .01), acute kidney injury (P < .01), and INTERMACS score (P = .01) in the bivariate analysis but not in the multivariate model.Conclusions
Clinical and nutritional factors had no impact on mortality up to 30 days after heart transplantation in this study, although orotracheal intubation duration, postoperative creatinine, acute kidney injury, and INTERMACS score were individually associated with early death. 相似文献15.
M.-S. Park S.K. Kim H.J. Park H. Seok S.W. Kang S.H. Lee Y.G. Kim J.Y. Moon T.H. Kim Y.H. Kim S.W. Kang J.-H. Chung K.H. Jeong 《Transplantation proceedings》2017,49(5):1012-1017
Objective
Bone morphogenetic proteins (BMP) belong to the transforming growth factor beta superfamily of proteins. This study was performed to evaluate the association of BMP gene polymorphisms with acute renal allograft rejection (AR) and graft dysfunction (GD) in Koreans.Methods
Three hundred thirty-one patients who had kidney transplantation procedures were recruited. Transplantation outcomes were determined in terms of AR and GD criteria. We selected six single nucleotide polymorphisms (SNPs): rs1979855 (5′ near gene), rs1049007 (Ser87Ser), rs235767 (intron), rs1005464 (intron), rs235768 (Arg190Ser), and rs3178250 (3; untranslated region).Results
Among the six SNPs tested, the rs235767, rs1005464, and rs3178250 SNPs were significantly associated with AR (P < .05). The rs1049007 and rs235768 SNPs also showed an association with GD (P < .05).Conclusions
In conclusion, these results suggest that the BMP2 gene polymorphism may be related to the development of AR and GD in kidney transplant recipients. 相似文献16.
Average Tacrolimus Trough Level in the First Month After Transplantation May Predict Acute Rejection
S. Aktürk Ş. Erdoğmuş G. Kumru A.H. Elhan Ş. Şengül A. Tüzüner K. Keven 《Transplantation proceedings》2017,49(3):430-435
Background
Although tacrolimus is one of the essential drugs used for the prevention of rejection in kidney recipients, target trough levels are not well established. In this study, we aimed to investigate the association between average tacrolimus trough levels (TTLs) of the first month after transplantation and biopsy-proven acute rejection (BPAR) during the first 12 months after transplant.Methods
A total of 274 patients who underwent kidney-alone transplantation between 2002 and 2014 were enrolled in the study. Average TTLs of the first month were assessed by means of receiver operating characteristic (ROC) curve analysis to discriminate patients with and those without BPAR. Univariate and multivariate Cox proportional hazards models were used to determine the effect of average TTLs of the first month on BPAR.Results
According to ROC curve analysis, the highest area under the curve (AUC) was obtained from 8 ng/mL (AUC = 0.73 ± 0.11; 95% confidence interval [CI], 0.62–0.84). Forty-two (31.8%) of the 132 patients with average TTLs <8 ng/mL and 13 (9.1%) of 142 patients with ≥8 ng/mL had BPAR during the first 12 months after transplant (P < .001). In univariable analysis, average TTLs of the first month <8 ng/mL were associated with higher risk of BPAR (P < .001), and the significance remained in Cox multivariable analysis (hazard ratio, 2.79; 95% CI, 1.76–3.82; P = .001). No significant differences were observed in the glomerular filtration rate, cytomegalovirus, BK viremia, or BK nephropathy between groups at post-transplant month 12.Conclusions
Keeping the average TTLs of the first month after transplantation at ≥8 ng/mL not only prevents BPAR occurrence but also minimizes the toxic effects of the use of a single-trough level. 相似文献17.
K. Ko Y.H. Kim M.H. Kim K.W. Jun J.K. Hwang S.D. Kim S.C. Park J.I. Kim I.S. Moon 《Transplantation proceedings》2017,49(5):982-986
Purpose
Our objective was to investigate the effects of age on patient and graft survival in expanded criteria donor (ECD) renal transplantation.Methods
Between February 2000 and December 2015, we analyzed 405 deceased donor renal transplants, including 128 grafts (31.9%) from ECDs. Based on recipient age and ECD criteria classification, the recipients were divided into four groups: Group I, non-ECD to recipient age <50 years; Group II, non-ECD to recipient age ≥50 years; Group III, ECD to recipient age <50 years; and Group IV, ECD to recipient age ≥50 years.Results
Among the four groups, there were significant differences in baseline characteristics (age, body mass index [BMI], cause of end-stage renal disease [ESRD], number of kidney transplantations, and use of induction agent). The mean modification of diet in renal disease (MDRD) glomerular filtration rate (GFR) level at 1 month, 6 months, 1 year, 3 years, and 5 years after transplantation was significantly lower in patients with ECDs but MDRD GFR level at 7, 9, and 10 years did not differ significantly (P = .183, .041, and .388, respectively). There were no significant differences in graft survival (P = .400) and patient survival (P = .147).Conclusion
Our result shows that, regardless of recipient age, kidney transplants donated by deceased ECDs have similar graft and patient survival. 相似文献18.
E.A. Hassan T.Z. Ali A. Abdulbaki I.A. Ibrahim H.M. Almanae H.A. Aleid 《Transplantation proceedings》2017,49(8):1729-1732
Introduction
Isolated microscopic hematuria (IMH) is not uncommon in potential kidney donors.Aim
The aim was to study the kidney biopsy findings of potential kidney donors with IMH and the impact of the histopathologic diagnoses on the decision to accept or decline such donors from kidney donation.Methods
In this retrospective study, all the potential kidney donors with IMH were identified from the medical records of patients who underwent kidney biopsies between January 2010 and December 2016.Results
Forty-five such individuals were identified. The mean age of these potential donors was 32.6 years and 76% were male. All of them had normal blood pressure and no significant proteinuria. Seventeen (38%) biopsies showed histopathologic abnormalities; thin basement membrane disease (n = 13; 28%) was the most common cause followed by immunoglobulin (Ig)A nephropathy (n = 4; 9%). Donors with abnormal biopsy findings were excluded from donation. However, 62% of the potential donors had normal kidney biopsy findings and were accepted for kidney donation.Conclusion
IMH justifies extensive work-up including kidney biopsy to identify donors who may have underlying significant glomerular pathology excluding them from kidney donation. On the other hand, kidney biopsy also helps in accepting the donors if it does not show significant abnormality. 相似文献19.
J.A. Carvalho P. Nunes P.J. Dinis H. Antunes B. Parada L. Marconi P. Moreira A. Roseiro C. Bastos F. Rolo V. Dias A. Figueiredo 《Transplantation proceedings》2017,49(4):809-812
Background
We currently know that prostate cancer (Pca) risk is reduced in patients undergoing kidney transplantation. However, its impact and treatment are not widely studied.Methods
This was a retrospective study of male patients submitted to kidney transplantation in our center from 1980 to 2016 evaluating incidence, treatment, and follow-up of Pca in our population.Results
In 1805 patients undergoing kidney transplantation, 20 men were diagnosed with Pca, leading to an incidence of 1.1%. Median age at renal transplantation was 53.4 years with a median age at diagnosis of Pca of 61.2 years. Initial median prostate-specific antigen (PSA) was 6 ng/mL and Gleason score was 7 (3 + 4) in about 50% of cases. Bone metastasis developed in 10% and no visceral metastases were diagnosed. The majority of patients were submitted to radical prostatectomy and bilateral pelvic lymph node dissection. Some other cancers occurred in these patients such as skin and pulmonary cancers. In 35% of the cases, the graft was lost. The main cause of patient death was cardiovascular. The mean graft survival was about 14 years. The majority of patients are alive with functioning grafts (65%).Conclusion
In our center the clinical incidence of Pca in patients undergoing kidney transplantation is 1.1% and surgical treatment seems to be a good initial option. 相似文献20.
G. Mattei A. Laghi S. Balduzzi M. Moscara C. Piemonte C. Reggianini M. Rigatelli S. Ferrari L. Pingani G.M. Galeazzi 《Transplantation proceedings》2017,49(9):2105-2109