Live donor renal transplantation in patients with end-stage renal failure due to IgA nephropathy: clinicopathological assessment

The treatment of choice for end-stage renal failure within the first year of life is controversial. Between September 1970 and February 1991, we performed 28 kidney transplants (27 primary, 1 retransplant, 23 living donor, 5 cadaver) in infants less than 1 yr of age (mean, 7 +/- 2 months; range, 6 wk to 12 months). The 1-yr patient survival rate for living donor recipients was 100% versus 20% for cadaver recipients (P = 0.0001). The 1-yr graft survival rate for living donor recipients was 96% versus 20% for cadaver recipients (P = 0.001). The 1-yr patient survival rate for cyclosporin A (CSA) recipients (N = 12) was 100% versus 75% for non-CSA recipients (P = 0.03). The 1-yr graft survival rate for CSA recipients was 92% versus 75% for non-CSA recipients (P = 0.08). There was no difference in the number of rejection episodes or serum creatinine levels in CSA versus non-CSA recipients. Compared with pretransplant values, the mean posttransplant standard deviation scores (SDS) for height (N = 18), weight (N = 22), and head circumference (N = 8) improved: height SDS from -1.9 to -1.5 (not significant); weight SDS from -2.5 to 0.6 (P less than 0.0005); head circumference SDS from -2.0 to -0.7 (P = 0.01). Because no other renal replacement therapy can match these results, we conclude that renal transplantation is the treatment of choice for infants with end-stage renal failure.

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Clam ileoplasty bladder augmentation and renal transplantation

Acta chirurgica iugoslavica ◽

10.2298/aci0704079m ◽

2007 ◽

Vol 54 (4) ◽

pp. 79-81

Author(s):

D. Milutinovic ◽

C. Topuzovic ◽

J. Hadzi-Djokic

Keyword(s):

Renal Failure ◽

Kidney Transplantation ◽

Renal Transplantation ◽

Bladder Augmentation ◽

Bladder Function ◽

End Stage Renal Failure ◽

Clam Ileocystoplasty ◽

End Stage

In our patient, with a small contacted bladder and end stage renal failure, bladder augmentation (clam ileocystoplasty) was done in conjunction with renal transplantation. Our patient has stable renal and bladder function 46 months after kidney transplantation.

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Renal transplantation and quality of life in Tanzania

Tanzania Medical Journal ◽

10.4314/tmj.v31i1.324 ◽

2020 ◽

Vol 31 (1) ◽

pp. 1-15

Author(s):

Onesmo A. Kisanga ◽

Francis F. Furia ◽

Paschal J. Ruggajo ◽

Eden E. Maro

Keyword(s):

Quality Of Life ◽

Renal Failure ◽

Kidney Transplantation ◽

Renal Transplantation ◽

Renal Transplant Recipients ◽

End Stage Renal Failure ◽

Laboratory Test Results ◽

The Government ◽

End Stage

Background: Renal replacement therapy (RRT), which includes dialysis and kidney transplantation, is the treatment of choice for patients with end stage renal failure (ESRF). Most sub-Saharan African countries have not developed renal transplantation services and are relying on referring patients to overseas countries. This study was carried out to describe renal transplantation experience in Tanzania.Methods: Forty-four renal transplant recipients were recruited in this study. Standardized questionnaire and Swahili version of standard form – 36 (SF-36) were used to collect socio-demographic information, clinical data, laboratory test results and health related quality of life information.Results: Ages of transplant recipient ranged from 21 to 66 years with mean age of 45.9 ± 10.5 years. The leading causes of end stage renal failure among participants was hypertension 58.8% (25/44) followed by glomerulonephritis 15.9% (7/44). Twentyeight (63.6%) of transplantations were paid by the government. Most of the donors (97.7%) were living out of which 26 (59.1%) were siblings and 11 (25%) were second-degree relatives (cousins and nephews). Most common complication noted following transplantation was diabetes mellitus 9 (20.5%) and 3 (6.8%) had chronic rejection. Mental health was the domain with highest mean score (75.6 ± 14.3) and role physical had the least mean score (44 ± 45.6).Conclusions: Hypertension was the leading cause of ESRF in this study. Most of the donors were siblings and the costs of transplantation were largely covered by the government. There is a need for concerted effort to establish local kidney transplantation services in Tanzania. Keywords: Renal transplantation, quality of life in transplantation, Tanzania.

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Transplantation

Paediatric Surgery ◽

10.1093/med/9780198798699.003.0011 ◽

2020 ◽

pp. 449-466

Keyword(s):

Liver Transplantation ◽

Renal Failure ◽

Renal Transplantation ◽

Cardiac Transplantation ◽

Intestinal Transplantation ◽

Postoperative Management ◽

Mechanical Support ◽

End Stage Renal Failure ◽

End Stage

This chapter begins with an introduction to transplant surgery with its intriguing history and development as a specialty. The general principles of biological rejection are covered on a background of immunology and immunosuppression. Clinical transplants in children are detailed with the first and most well-established being renal transplantation . The causes of end-stage renal failure are listed with further details of preparation, the operation itself, and potential complications. Cardiac transplantation is fully discussed, including indications, contraindications, the role of mechanical support, surgery for the donor and the recipient, complications, and postoperative management. Liver transplantation is covered in detail, including listing for a transplant, choice of a suitable donor, the surgical procedure, and outcomes and complications. Finally, intestinal transplantation is covered with discussion on indications, potential complications, and outcomes.

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