Comparison of machine perfusion versus cold storage in kidney transplant recipients from expanded criteria donors: a cohort-based study

2019 ◽  
Vol 35 (6) ◽  
pp. 1051-1059 ◽  
Author(s):  
Yohann Foucher ◽  
Marie-Cécile Fournier ◽  
Christophe Legendre ◽  
Emmanuel Morelon ◽  
Fanny Buron ◽  
...  
Keyword(s):  
Cold Storage ◽  
Group Versus ◽  
Long Term Results ◽  
Acute Rejection Episode ◽  
Machine Perfusion ◽  
Kidney Transplant Recipients ◽  
Short Term ◽  
Post Transplantation ◽  
Cox Models ◽  
Expanded Criteria

Abstract Background Most studies comparing the efficacy of hypothermic machine perfusion (HMP) versus static cold storage (SCS) are based on short-term outcomes. We aimed to better evaluate the mid-term impact of HMP in patients receiving expanded criteria donor (ECD) kidneys. Methods The analyses were based on the French Données Informatisées et VAlidées en Transplantation (DIVAT) observational cohort. Patients aged ≥45 years transplanted for the first or second times from an ECD donor since 2010 were studied. Our study reported the graft and/or patient survivals and the incidence of acute rejection episode. The Cox models and the Kaplan–Meier estimators, weighted on the propensity score, were used to study the times-to-events. Results Among the 2019 included patients, 1073 were in the SCS group versus 946 in the HMP group. The mean life expectancy with functioning graft was 5.7 years [95% confidence interval (CI) 5.4–6.1] for the HMP cohort followed-up for 8 years post-transplantation versus 6.0 years (95% CI 5.7–6.2) for the SCS group. These mid-term results were comparable in the patients receiving grafts from donors aged ≥70 years and in the transplantations with cold ischaemia time ≥18 h. Conclusions Our study challenges the utility of using HMP to improve mid-term patient and graft survival. Nevertheless, the improvement of the short-term outcomes is indisputable. It is necessary to continue technological innovations to obtain long-term results.

scholarly journals Machine perfusion versus static cold storage in expanded criteria donor kidney transplantation: 3-year follow-up data

2013 ◽  
Vol 26 (6) ◽  
pp. E52-E53 ◽  
Author(s):  
Anja Gallinat ◽  
Cyril Moers ◽  
Jacqueline M. Smits ◽  
Agita Strelniece ◽  
Jacques Pirenne ◽  
...  
Keyword(s):  
Kidney Transplantation ◽  
Cold Storage ◽  
Machine Perfusion ◽  
Donor Kidney ◽  
Expanded Criteria Donor ◽  
Expanded Criteria ◽  
Donor Kidney Transplantation

scholarly journals Machine perfusion versus cold storage for preservation of kidneys from expanded criteria donors after brain death

2011 ◽  
Vol 24 (6) ◽  
pp. 548-554 ◽  
Author(s):  
Jürgen Treckmann ◽  
Cyril Moers ◽  
Jacqueline M. Smits ◽  
Anja Gallinat ◽  
Mark-Hugo J. Maathuis ◽  
...  
Keyword(s):  
Brain Death ◽  
Cold Storage ◽  
Machine Perfusion ◽  
Expanded Criteria ◽  
Expanded Criteria Donors

scholarly journals BK Polyomavirus Micro-RNAs: Time Course and Clinical Relevance in Kidney Transplant Recipients

Viruses ◽  
2021 ◽  
Vol 13 (2) ◽  
pp. 351
Author(s):  
Baptiste Demey ◽  
Véronique Descamps ◽  
Claire Presne ◽  
Francois Helle ◽  
Catherine Francois ◽  
...  
Keyword(s):  
Viral Replication ◽  
Kidney Transplant ◽  
Clinical Relevance ◽  
Graft Loss ◽  
First Year ◽  
Transplant Recipients ◽  
Kidney Transplant Recipients ◽  
Post Transplantation ◽  
Bk Polyomavirus ◽  
Micro Rnas

Background: Kidney transplant recipients (KTRs) are exposed to a high risk of BK polyomavirus (BKPyV) replication, which in turn may lead to graft loss. Although the microRNAs (miRNAs) bkv-miR-B1-3p and bkv-miR-B1-5p are produced during the viral cycle, their putative value as markers of viral replication has yet to be established. In KTRs, the clinical relevance of the changes over time in BKPyV miRNA levels has not been determined. Methods: In a retrospective study, we analyzed 186 urine samples and 120 plasma samples collected from 67 KTRs during the first year post-transplantation. Using a reproducible, standardized, quantitative RT-PCR assay, we measured the levels of bkv-miR-B1-3p and bkv-miR-B1-5p (relative to the BKPyV DNA load). Results: Detection of the two miRNAs had low diagnostic value for identifying patients with DNAemia or for predicting DNAuria during follow-up. Seven of the 14 KTRs with a sustained BKPyV infection within the first year post-transplantation showed a progressive reduction in the DNA load and then a rapid disappearance of the miRNAs. DNA and miRNA loads were stable in the other seven KTRs. Conclusions: After the DNA-based diagnosis of BKPyV infection in KTRs, bkv-miR-B1-3p and bkv-miR-B1-5p levels in the urine might be valuable markers for viral replication monitoring and thus might help physicians to avoid an excessive reduction in the immunosuppressive regimen.

scholarly journals Association of early glycemic change with short-term mortality in lobar and non-lobar intracerebral hemorrhage

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Paola Forti ◽  
Fabiola Maioli ◽  
Marco Zoli
Keyword(s):  
Intracerebral Hemorrhage ◽  
Continuous Variable ◽  
Serum Glucose ◽  
Diabetic Patients ◽  
Short Term ◽  
Cox Models ◽  
Short Term Mortality ◽  
Glucose Test ◽  
Acute Intracerebral Hemorrhage ◽  
Persistent Hyperglycemia

AbstractThe association between early glycemic change and short-term mortality in non-diabetic patients with acute intracerebral hemorrhage (ICH) is unclear. We retrospectively investigated non-diabetic patients with lobar (n = 262) and non-lobar ICH (n = 370). Each patient had a random serum glucose test on hospital admission and a fasting serum glucose test within the following 48 h. Hyperglycemia was defined as serum glucose ≥ 7.8 mmol/l. Four patterns were determined: no hyperglycemia (reference category), persistent hyperglycemia, delayed hyperglycemia, and decreasing hyperglycemia. Associations with 30-day mortality were estimated using Cox models adjusted for major features of ICH severity. Persistent hyperglycemia was associated with 30-day mortality in both lobar (HR 3.00; 95% CI 1.28–7.02) and non-lobar ICH (HR 4.95; 95% CI 2.20–11.09). In lobar ICH, 30-day mortality was also associated with delayed (HR 4.10; 95% CI 1.77–9.49) and decreasing hyperglycemia (HR 2.01, 95% CI 1.09–3.70). These findings were confirmed in Cox models using glycemic change (fasting minus random serum glucose) as a continuous variable. Our study shows that, in non-diabetic patients with ICH, early persistent hyperglycemia is an independent predictor of short-term mortality regardless of hematoma location. Moreover, in non-diabetic patients with lobar ICH, both a positive and a negative glycemic change are associated with short-term mortality.

scholarly journals B-cell activating factor BAFF as a novel alert marker for the immunological risk stratification after kidney transplantation

2021 ◽  
Author(s):  
Antonia Margarete Schuster ◽  
N. Miesgang ◽  
L. Steines ◽  
C. Bach ◽  
B. Banas ◽  
...  
Keyword(s):  
Kidney Transplantation ◽  
B Cell ◽  
Graft Function ◽  
Risk Profile ◽  
Kidney Transplant Recipients ◽  
Post Transplantation ◽  
Antibody Mediated Rejection ◽  
B Cell Activating Factor ◽  
Medium Risk ◽  
Patients At Risk

AbstractThe B cell activating factor BAFF has gained importance in the context of kidney transplantation due to its role in B cell survival. Studies have shown that BAFF correlates with an increased incidence of antibody-mediated rejection and the development of donor-specific antibodies. In this study, we analyzed a defined cohort of kidney transplant recipients who were treated with standardized immunosuppressive regimens according to their immunological risk profile. The aim was to add BAFF as an awareness marker in the course after transplantation to consider patient’s individual immunological risk profile. Included patients were transplanted between 2016 and 2018. Baseline data, graft function, the occurrence of rejection episodes, signs of microvascular infiltration, and DSA kinetics were recorded over 3 years. BAFF levels were determined 14 d, 3 and 12 months post transplantation. Although no difference in graft function could be observed, medium-risk patients showed a clear dynamic in their BAFF levels with low levels shortly after transplantation and an increase in values of 123% over the course of 1 year. Patients with high BAFF values were more susceptible to rejection, especially antibody-mediated rejection and displayed intensified microvascular inflammation; the combination of high BAFF + DSA puts patients at risk. The changing BAFF kinetics of the medium risk group as well as the increased occurrence of rejections at high BAFF values enables BAFF to be seen as an awareness factor. To compensate the changing immunological risk, a switch from a weaker induction therapy to an intensified maintenance therapy is required.

Long-Term Results of Radioscapholunate Fusion Following Fractures of the Distal Radius

1997 ◽  
Vol 22 (6) ◽  
pp. 705-710 ◽  
Author(s):  
L. NAGY ◽  
U. BÜCHLER
Keyword(s):  
Long Term Results ◽  
Short Term ◽  
Non Union ◽  
Partial Fusion ◽  
Traumatic Lesions ◽  
Residual Motion ◽  
Radioscapholunate Fusion ◽  
Wrist Fusion

Fifteen patients with radioscapholunate (RSL) fusion for traumatic lesions of the radiocarpal junction, whose short-term results have been previously reported, were reassessed after an average follow-up time of 8 years. Five patients had undergone wrist fusion because of non-union or early progressive arthritis. Of the ten wrists with retained mobility, eight continued to function satisfactorily. Two wrists were painful for reasons other than secondary midcarpal arthritis. Patient satisfaction was comparable in both groups with the wrist score better for wrists with residual motion. The survival of RSL partial wrist fusion corresponded inversely with the number of preceding operations and the range of motion before partial fusion. Secondary midcarpal arthritis, if present, arose early and was well tolerated. Failures were strongly linked to technical mistakes and complications.

Long-Term Deformations of Strengthened Reinforced Concrete Linear Elements

2016 ◽  
Vol 691 ◽  
pp. 51-60 ◽  
Author(s):  
Martin Krizma ◽  
Lubomir Bolha
Keyword(s):  
Reinforced Concrete ◽  
Long Term Results ◽  
Short Term ◽  
Limit States ◽  
Linear Elements ◽  
Repeated Load ◽  
The Moment ◽  
Concrete Elements ◽  
Fiber Fabric

The issue of strengthening the damaged linear reinforced concrete elements have been engaged since 2008. We focused on the analysis of resistance and the characteristics of limit states of serviceability in the damaged and subsequently strengthened elements at a short-term loading. In the introduction phase, the strengthening of the elements was carried out with the following procedures – installation of an overlayer on the coupling board or a combination of the board and use of glass – fiber fabric (GFRP). The strengthening was also affected by the type of contact (reinforced/non-reinforced) – the deformed element/coupling board and its effect on resistance, type of deformation and serviceability. In the non-reinforced contact, we applied some of the types of adjustments to the surface of the strengthened element. At the moment, we are dealing with the effects of time and repeated load on the strengthened elements. The results correspond to the reinforced contact. The values are compared with the short-term results of the strengthened beams and with the long-term results of the beams prepared for strengthening.

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