Impact of the explanting surgeon’s impression of donor arteriosclerosis on outcome of kidney transplantations from donors aged ≥65 years

2021 ◽  
Author(s):  
Fabian Echterdiek ◽  
Constantin Tilgener ◽  
Jürgen Dippon ◽  
Daniel Kitterer ◽  
Justus Scheder-Bieschin ◽  
...  
Keyword(s):  
Kidney Transplantations

scholarly journals Epidemiology, Risk Factors, and Outcomes of Opportunistic Infections after Kidney Allograft Transplantation in the Era of Modern Immunosuppression: A Monocentric Cohort Study

2019 ◽  
Vol 8 (5) ◽  
pp. 594 ◽  
Author(s):  
Philippe Attias ◽  
Giovanna Melica ◽  
David Boutboul ◽  
Nathalie De Castro ◽  
Vincent Audard ◽  
...  
Keyword(s):  
Risk Factors ◽  
Protective Factor ◽  
Opportunistic Infections ◽  
Control Group ◽  
Kidney Allograft ◽  
Extended Criteria Donor ◽  
Allograft Transplantation ◽  
Kidney Recipients ◽  
Independent Risk Factors ◽  
Kidney Transplantations

Epidemiology of opportunistic infections (OI) after kidney allograft transplantation in the modern era of immunosuppression and the use of OI prevention strategies are poorly described. We retrospectively analyzed a single-center cohort on kidney allograft adult recipients transplanted between January 2008 and December 2013. The control group included all kidney recipients transplanted in the same period, but with no OI. We analyzed 538 kidney transplantations (538 patients). The proportion of OI was 15% (80 and 72 patients). OI occurred 12.8 (6.0–31.2) months after transplantation. Viruses were the leading cause (n = 54, (10%)), followed by fungal (n = 15 (3%)), parasitic (n = 6 (1%)), and bacterial (n = 5 (0.9%)) infections. Independent risk factors for OI were extended criteria donor (2.53 (1.48–4.31), p = 0.0007) and BK viremia (6.38 (3.62–11.23), p < 0.0001). High blood lymphocyte count at the time of transplantation was an independent protective factor (0.60 (0.38–0.94), p = 0.026). OI was an independent risk factor for allograft loss (2.53 (1.29–4.95), p = 0.007) but not for patient survival. Post-kidney transplantation OIs were mostly viral and occurred beyond one year after transplantation. Pre-transplantation lymphopenia and extended criteria donor are independent risk factors for OI, unlike induction therapy, hence the need to adjust immunosuppressive regimens to such transplant candidates.

scholarly journals Clinical impact of serum bilirubin levels on kidney transplant outcomes

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Juhan Lee ◽  
Eun Jin Kim ◽  
Jae Geun Lee ◽  
Beom Seok Kim ◽  
Kyu Ha Huh ◽  
...  
Keyword(s):  
Kidney Transplant ◽  
Graft Failure ◽  
Serum Bilirubin ◽  
Graft Loss ◽  
Multivariable Analysis ◽  
Post Transplantation ◽  
Transplant Outcomes ◽  
Increased Risk ◽  
All Cause Mortality ◽  
Kidney Transplantations

AbstractSerum bilirubin, a potent endogenous antioxidant, has been associated with decreased risks of cardiovascular disease, diabetes, and kidney disease. However, the effects of serum bilirubin on kidney transplant outcomes remain undetermined. We analyzed 1628 patients who underwent kidney transplantations between 2003 and 2017. Patients were grouped into sex-specific quartiles according to mean serum bilirubin levels, 3–12 months post-transplantation. Median bilirubin levels were 0.66 mg/dL in males and 0.60 mg/dL in females. The intra-individual variability of serum bilirubin levels was low (9%). Serum bilirubin levels were inversely associated with graft loss, death-censored graft failure, and all-cause mortality, independent of renal function, donor status, and transplant characteristics. Multivariable analysis revealed that the lowest serum bilirubin quartile was associated with increased risk of graft loss (HR 2.64, 95% CI 1.67–4.18, P < 0.001), death-censored graft failure (HR 2.97, 95% CI 1.63–5.42, P < 0.001), and all-cause mortality (HR 2.07, 95% CI 1.01–4.22, P = 0.046). Patients with lower serum bilirubin were also at greater risk of rejection and exhibited consistently lower glomerular filtration rates than those with higher serum bilirubin. Serum bilirubin levels were significantly associated with transplantation outcomes, suggesting that bilirubin could represent a therapeutic target for improving long-term transplant outcomes.

LONG-TERM GRAFT SURVIVAL AFTER UROLOGICAL COMPLICATIONS OF 695 KIDNEY TRANSPLANTATIONS

2001 ◽  
Vol 165 (6 Part 1) ◽  
pp. 1884-1887 ◽  
Author(s):  
J. HERMAN van ROIJEN ◽  
WIM J. KIRKELS ◽  
ROBERT ZIETSE ◽  
JOKE I. ROODNAT ◽  
WILLEM WEIMAR ◽  
...  
Keyword(s):  
Graft Survival ◽  
Urological Complications ◽  
Kidney Transplantations

The Stockholm experience with ABO-incompatible kidney transplantations without splenectomy.

2006 ◽  
Vol 13 (2) ◽  
pp. 105-107 ◽  
Author(s):  
Gunnar Tyden ◽  
Gunilla Kumlien ◽  
Helena Genberg ◽  
John Sandberg ◽  
Amir Sedigh ◽  
...  
Keyword(s):  
Kidney Transplantations

Various vascular procedures in kidney transplantations

1998 ◽  
Vol 30 (7) ◽  
pp. 3006 ◽  
Author(s):  
I Moon ◽  
Y Kim ◽  
J Park ◽  
S Kim ◽  
Y Koh
Keyword(s):  
Kidney Transplantations

scholarly journals Analysis of donor selection for living related kidney transplantation and their postoperative outcome

2002 ◽  
Vol 130 (5-6) ◽  
pp. 193-197
Author(s):  
Visnja Lezaic ◽  
Ljubica Djukanovic ◽  
Dragana Radivojevic-Djokic ◽  
Radmila Blagojevic-Lazic ◽  
Stojanka Ristic ◽  
...  
Keyword(s):  
Kidney Transplantation ◽  
Selection Procedure ◽  
Postoperative Outcome ◽  
Careful Examination ◽  
Family Relation ◽  
Abo Incompatibility ◽  
Living Donor Transplantation ◽  
Kidney Transplantations ◽  
Living Related ◽  
Drop Outs

Lack of cadaveric organs for transplantation resulted in increased number of living related kidney donors examinations and consequent transplantations in our Department. Donor procedure, selection, drop-outs and final results for living related donors (LRD) were retrospectively analyzed in this paper. Between 1987 and 1994 202 potential LRD were examined. Most of them were females (59%) and about 30% were older than 60 years. The family relation between LRD and recipients were: parents (95%), siblings (3%), grandmother grandfather (1.5%) and uncle (0.5%). Potential LRD were informed on risks advantages and procedure of living donor transplantation. After primary information 26% of potential LRD gave up further examinations. Following immunological and clinical evaluations 48% of LRD actually donated a kidney. The other 26% were excluded during the selection procedure. High immunological risks including ABO incompatibility, HLA mismatches and positive cross match test were the reasons for drop outs of 35 potential LRD (17%). Five more donors were excluded for medical reasons: one because of low creatinine clearance and four because of neoplasms, discovered during examination (kidney, laryngeal, lung). Fourteen transplantation were not realized due to different recipient reasons: 5 of them had clinical contraindications, two died and in 7 cadaveric kidney transplantations were performed. Mild hypertension, coronary disease and diabetes mellitus type 2 were presented in 5 LRD accepted for transplantation. Five more had to be operated before donation (abdominal or urological operation). Early complications after donor nephrectomy were acute renal failure, stress ulcus, pleuropneumonia in three and thromboflebitis in two donors. In conclusion, although kidney transplantation from LRD is highly successful careful examination during selection procedure is indispensable.

Long-term results of 1047 cadaveric kidney transplantations with special emphasis on initial graft function and rejection

2000 ◽  
Vol 13 (2) ◽  
pp. 122-128 ◽  
Author(s):  
L. E. J. Kyllönen ◽  
K. T. Salmela ◽  
B. H. Eklund ◽  
L. E. H. Halme ◽  
K. A. V. Höckerstedt ◽  
...  
Keyword(s):  
Graft Function ◽  
Long Term Results ◽  
Kidney Transplantations ◽  
Cadaveric Kidney

FC 117TIME TRENDS IN PROBABILITY OF STARTING HOME DIALYSIS OVER A 20 YEAR PERIOD: A DUTCH REGISTRY STUDY

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
Anna Bonenkamp ◽  
Tiny Hoekstra ◽  
Marc Hemmelder ◽  
Anita Van Eck van der Sluijs ◽  
Alferso C Abrahams ◽  
...  
Keyword(s):  
Kidney Transplantation ◽  
The Netherlands ◽  
Risk Model ◽  
The Elderly ◽  
Dialysis Patients ◽  
Dialysis Treatment ◽  
Home Dialysis ◽  
System Utilization ◽  
Number Of Patients ◽  
Kidney Transplantations

Abstract Background and Aims A growing number of patients suffers from End Stage Kidney Disease(ESKD), causing a logistical and economic burden to the healthcare system. Utilization of home dialysis is low in many countries worldwide, although home dialysis has several advantages including higher quality of life and possibly lower costs. The aim of this study is to explore time trends in the use of home dialysis in the Netherlands. Method Anonymized registry data from the Dutch Renal Registry (RENINE) were used for this study. All dialysis episodes of adult patients who started dialysis treatment between 1997 through 2016 in the Netherlands were included, including those who previously underwent kidney transplantation. Dialysis episodes shorter than 90 days were excluded. The probability of starting home dialysis between 1997 through 2016 was evaluated in time periods of 5 years, using logistic regression analysis. Home dialysis was defined as start with peritoneal dialysis or home haemodialysis, or transfer to either within 2 years after dialysis start. A logistic multilevel model was used to adjust for clustering at patient level. The cumulative incidence function of start of home dialysis in incident patients was estimated with a competing risk model with recovery of kidney function, kidney transplantations, and all-cause mortality as competing events. All analyses were stratified for age categories at dialysis start: 20-44 years, 45-64 years, 65-74 years and ≥75 years. Results A total of 33,340 dialysis episodes in 31,569 patients were evaluated. Between 1997 and 2016, mean age at start of dialysis treatment increased from 62.5±14.0 to 65.5±14.5 years in in-centre haemodialysis patients, whereas it increased from 51.9±15.1 to 62.5±14.6 years in home dialysis patients. In patients &lt; 65 years, the probability of starting home dialysis was significantly lower during each 5-year period compared to the previous period, and kidney transplantation occurred more often. In patients ≥ 65 years, incidence of home dialysis remained constant, whereas mortality decreased. Conclusion In patients &lt; 65 years, the overall probability of starting home dialysis declined consistently over the past 20 years. The age of home dialysis patients increased more rapidly than that of in-centre dialysis patients, implying that pre-dialysis education and organization of home dialysis must be adapted to the needs of the elderly patient. These developments have a significant impact on the organisation of home dialysis for patients with ESKD.

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