Case 7.31

2014 ◽  
pp. 364-365
Author(s):  
Christine U. Lee ◽  
James F. Glockner
Keyword(s):  
Renal Function ◽  
Renal Transplantation ◽  
Renal Transplant ◽  
Cardiac Function ◽  
Focal Segmental Glomerulosclerosis ◽  
Signal Intensity ◽  
Diffuse Alveolar Hemorrhage ◽  
Lower Quadrant ◽  
Right Lower Quadrant ◽  
New Onset

19-year-old man with recent renal transplantation for focal segmental glomerulosclerosis who now has declining renal function and new-onset diffuse alveolar hemorrhage and reduced cardiac function Axial SSFSE images (Figure 7.31.1) reveal diffuse increased signal intensity throughout the featureless right lower quadrant renal transplant. Axial postgadolinium 2D SPGR images (...

scholarly journals Late renal vein aneurysm following living related renal transplant

2014 ◽  
Vol 8 (3-4) ◽  
pp. 253 ◽  
Author(s):  
Robert Thomas Dale ◽  
Samir Bidnur ◽  
Christopher YC Nguan
Keyword(s):  
Renal Transplant ◽  
Renal Vein ◽  
Abdominal Ultrasound ◽  
New Right ◽  
Resonance Imaging ◽  
Lower Quadrant ◽  
Management Guidelines ◽  
Living Related ◽  
Ultrasound Investigation ◽  
Right Lower Quadrant

Renal vein aneurysms are rare; there are less than 10 reported cases. As of yet there have been no reported cases of renal vein aneurysm following renal transplantation. We present a case of an incidentally discovered renal vein aneurysm following uncomplicated living related renal transplant. The lesion was discovered 4 years after the transplant through abdominal ultrasound investigation of new right lower quadrant discomfort. Magnetic resonance imaging confirmed the presence of a 2.3-cm thrombosed renal vein aneurysm of the main renal vein. This case report highlights the rare nature of these events, the diagnostic challenges and the lack of satisfactory management guidelines in these cases.

scholarly journals Successful Treatment of Tuberculosis in Renal Transplant Recipients1

1978 ◽  
Vol 71 (4) ◽  
pp. 265-268 ◽  
Author(s):  
T J Bell ◽  
Grant B Williams
Keyword(s):  
Renal Function ◽  
Renal Transplantation ◽  
Renal Transplant ◽  
Successful Treatment ◽  
Fatal Complication

Tuberculosis is a rare and usually fatal complication of renal transplantation. From 82 transplants in seven years, 4 cases of tuberculosis are reported. All have been treated successfully, with no fatalities or deterioration in renal function.

scholarly journals Efficacy and Safety of Sitagliptin for the Treatment of New-Onset Diabetes after Renal Transplantation

2014 ◽  
Vol 2014 ◽  
pp. 1-9 ◽  
Author(s):  
Brian P. Boerner ◽  
Clifford D. Miles ◽  
Vijay Shivaswamy
Keyword(s):  
Renal Transplantation ◽  
Renal Transplant ◽  
Kidney Transplant ◽  
Hemoglobin A1c ◽  
Renal Transplant Recipients ◽  
Transplant Recipients ◽  
Kidney Transplant Recipients ◽  
First Line ◽  
New Onset

New-onset diabetes after transplantation (NODAT) is a common comorbidity after renal transplantation. Though metformin is the first-line agent for the treatment of type 2 diabetes, in renal transplant recipients, metformin is frequently avoided due to concerns about renal dysfunction and risk for lactic acidosis. Therefore, alternative first-line agents for the treatment of NODAT in renal transplant recipients are needed. Sitagliptin, a dipeptidyl-peptidase-4 (DPP-4) inhibitor, has a low incidence of hypoglycemia, is weight neutral, and, in a small study, did not affect immunosuppressant levels. However, long-term sitagliptin use for the treatment of NODAT in kidney transplant recipients has not been studied. We retrospectively analyzed renal transplant recipients diagnosed with NODAT and treated with sitagliptin to assess safety and efficacy. Twenty-two patients were started on sitagliptin alone. After 12 months of followup, 19/22 patients remained on sitagliptin alone with a significant improvement in hemoglobin A1c. Renal function and immunosuppressant levels remained stable. Analysis of long-term followup (32.5±17.8 months) revealed that 17/22 patients remained on sitagliptin (mean hemoglobin A1c < 7%) with 9/17 patients remaining on sitagliptin alone. Transplant-specific adverse events were rare. Sitagliptin appears safe and efficacious for the treatment of NODAT in kidney transplant recipients.

scholarly journals Clinical and genetic risk factors for new-onset diabetes mellitus after transplantation (NODAT) in major transplant centres in Malaysia

2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Rhanye Mac Guad ◽  
Andrew W. Taylor-Robinson ◽  
Yuan Seng Wu ◽  
Siew Hua Gan ◽  
Nur Lisa Zaharan ◽  
...  
Keyword(s):  
Renal Transplantation ◽  
Blood Glucose ◽  
Renal Transplant ◽  
Fasting Blood Glucose ◽  
Glucose Levels ◽  
Blood Glucose Levels ◽  
Increased Risk ◽  
Daily Dose ◽  
One Year ◽  
New Onset

Abstract Background New-onset diabetes after transplantation (NODAT) is associated with reduced patient and graft survival. This study examined the clinical and selected genetic factors associated with NODAT among renal-transplanted Malaysian patients. Methods This study included 168 non-diabetic patients (58% males, 69% of Chinese ethnicity) who received renal transplantation between 1st January 1994 to 31st December 2014, and were followed up in two major renal transplant centres in Malaysia. Fasting blood glucose levels were used to diagnose NODAT in patients who received renal transplantation within 1 year. Two single nucleotide polymorphisms (SNPs), namely; rs1494558 (interleukin-7 receptor, IL-7R) and rs2232365 (mannose-binding leptin-2, MBL2) were selected and genotyped using Sequenom MassArray platform. Cox proportional hazard regression analyses were used to examine the risk of developing NODAT according to the different demographics and clinical covariates, utilizing four time-points (one-month, three-months, six-months, one-year) post-transplant. Results Seventeen per cent of patients (n = 29, 55% males, 69% Chinese) were found to have developed NODAT within one-year of renal transplantation based on their fasting blood glucose levels. NODAT patients had renal transplantation at an older age compared to non-NODAT (39.3 ± 13.4 vs 33.9 ± 11.8 years, p = 0.03). In multivariate analysis, renal-transplanted patients who received a higher daily dose of cyclosporine (mg) were associated with increased risk of NODAT (Hazard ratio (HR) =1.01 per mg increase in dose, 95% confidence interval (CI) 1.00–1.01, p = 0.002). Other demographic (gender, ethnicities, age at transplant) and clinical factors (primary kidney disease, type of donor, place of transplant, type of calcineurin inhibitors, duration of dialysis pre-transplant, BMI, creatinine levels, and daily doses of tacrolimus and prednisolone) were not found to be significantly associated with risk of NODAT. GA genotype of rs1494558 (HR = 3.15 95% CI 1.26, 7.86) and AG genotype of rs2232365 (HR = 2.57 95% CI 1.07, 6.18) were associated with increased risk of NODAT as compared to AA genotypes. Conclusion The daily dose of cyclosporine and SNPs of IL-7R (rs1494558) and MBL2 (rs2232365) genes are significantly associated with the development of NODAT in the Malaysian renal transplant population.

scholarly journals Renal Transplant Hydroureteronephrosis as a Manifestation of Rejection: An Under-Recognized Entity?

2021 ◽  
pp. 87-94
Author(s):  
Ratna Acharya ◽  
Rasha Aly ◽  
Kiran Upadhyay
Keyword(s):  
Renal Function ◽  
Renal Transplant ◽  
Vesicoureteral Reflux ◽  
Late Onset ◽  
Tube Placement ◽  
Nephrostomy Tube ◽  
Allograft Dysfunction ◽  
Uroepithelial Cells ◽  
Pediatric Rt ◽  
New Onset

Hydroureteronephrosis (HUN) of the renal transplant (RT) can be obstructive or non-obstructive, refluxing or non-refluxing, and can cause allograft dysfunction. HUN of the RT as a manifestation of rejection is uncommon and has not been described in children. We describe two pediatric RT recipients who presented with late-onset HUN, 5 and 10 years after transplantation. Both had new-onset HUN which occurred at the time of rejection; HUN resolved in both patients after treatment of rejection. Renal function stabilized in both patients without the need for stent or nephrostomy tube placement. There was no obstruction or vesicoureteral reflux (VUR). Edema of the uroepithelial cells leading to transient obstruction causing HUN is a most likely explanation. We conclude that treatment of rejection in patients without obstruction or VUR may lead to resolution of HUN without the need for urological interventions.

scholarly journals Validation of Identified Susceptible Gene Variants for New-Onset Diabetes in Renal Transplant Recipients

2019 ◽  
Vol 8 (10) ◽  
pp. 1696 ◽  
Author(s):  
Hyeon Hwang ◽  
Kyung-Won Hong ◽  
Jin Kim ◽  
Yang Kim ◽  
Ju Moon ◽  
...  
Keyword(s):  
Renal Transplantation ◽  
Renal Transplant ◽  
Association Studies ◽  
Renal Transplant Recipients ◽  
Genome Wide Association Studies ◽  
Nucleotide Polymorphisms ◽  
Transplant Recipients ◽  
Onset Diabetes ◽  
Multiple Variables ◽  
New Onset

Genome-wide association studies (GWAS) and candidate gene approaches have identified single nucleotide polymorphisms (SNPs) associated with new-onset diabetes after renal transplantation (NODAT). We evaluated associations between NODAT and SNPs identified in previous studies. We genotyped 1102 renal transplant recipients from the Korean Organ Transplantation Registry (KOTRY) database; 13 SNPs were assessed for associations with NODAT (occurring in 254 patients; 23.0%), within one year after transplantation. The frequency of the T allele at KCNQ1 rs2237892 was significantly lower in patients with NODAT compared to control patients (0.30 vs. 0.39; p = 8.5 × 10−5). The T allele at rs2237892 was significantly associated with decreased risk of NODAT after adjusting for multiple variables, compared to the C allele (OR 0.63, 95% CI 0.51–0.79; p = 5.5 × 10−5). Dominant inheritance modeling showed that CT/TT genotypes were associated with a lower risk for development of NODAT (OR 0.56, 95% CI 0.42–0.76; p = 2.0 × 10−4) compared to the CC genotype. No other SNPs were associated with NODAT. Our study validated the protective effect of T allele at KCNQ1 rs2237892 on the development of NODAT in a large cohort of renal transplant recipients. Our findings on susceptibility variants might be a useful tool to predict NODAT development after renal transplantation.

1689-P: Perioperative Hyperglycemia around Renal Transplantation Surgery and the Development of New-Onset Diabetes Mellitus after Transplantation

Diabetes ◽  
2020 ◽  
Vol 69 (Supplement 1) ◽  
pp. 1689-P
Author(s):  
MARÍA LETICIA MÉNDEZ FERREIRA ◽  
ELVIO D. BUENO ◽  
ALDO BENITEZ ◽  
CONCEPCION M. PALACIOS ◽  
JORGE T. JIMENEZ ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Renal Transplantation ◽  
Transplantation Surgery ◽  
Onset Diabetes ◽  
New Onset Diabetes Mellitus ◽  
New Onset
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