Sequential genetic testing of living related donors for inherited renal disease to promote informed choice and enhance safety of living donation

2021 ◽  
Author(s):  
Christie P Thomas ◽  
Sonali Gupta ◽  
Margaret E Freese ◽  
Kanwaljit K Chouhan ◽  
Maisie I Dantuma ◽  
...  
Keyword(s):  
Genetic Testing ◽  
Renal Disease ◽  
Informed Choice ◽  
Living Donation ◽  
Living Related

Genetic testing, an informed choice

2001 ◽  
pp. 7-20 ◽  
Author(s):  
Agnes Bankier ◽  
David Cram
Keyword(s):  
Genetic Testing ◽  
Informed Choice

Pediatric Renal Transplantation

2018 ◽  
Author(s):  
Kristin Chenault
Keyword(s):  
Renal Disease ◽  
Pediatric Population ◽  
Obstructive Uropathy ◽  
Kidney Size ◽  
Dysplastic Kidney ◽  
Common Etiology ◽  
Kidney Transplantations ◽  
Stage Renal Disease ◽  
End Stage ◽  
Living Related

Approximately 700 pediatric kidney transplants were performed in 2014, with roughly one-third of those being living-related kidney transplantations. There are distinct differences between renal disease and transplantation in children compared to adults. Overall, end-stage renal disease (ESRD) is less common in the pediatric population than in adults. While the most common etiology for ESRD in adults is diabetes mellitus, the most common etiologies of ESRD in the pediatric population are congenital, such as dysplastic kidney or obstructive uropathy. Surgical technique can also vary depending on the age and size of the recipient, as well as the donor kidney size.

scholarly journals Genetic Diseases of the Kidney

2015 ◽  
Vol 8 (1) ◽  
pp. 136-147
Author(s):  
John Foreman
Keyword(s):  
Gene Therapy ◽  
Genetic Testing ◽  
Renal Disease ◽  
Genetic Diseases ◽  
Genetic Mutation ◽  
Renal Diseases ◽  
Genetic Mutations ◽  
Specific Gene ◽  
Number Of Genes ◽  
The Future

The number of genes associated with renal disease is increasing every day and this has led to a clearer understanding of the pathophysiology of renal disease in many disorders. It is also appreciated now that a genetic mutation(s) underlie many renal syndromes. Genetic testing may also offer the possibility to diagnose some renal diseases without the need for a renal biopsy. It also allows the prenatal diagnosis of certain renal diseases in at risk fetuses or identification of potential renal disease before it has become manifest. Finally, identification of a specific gene mutation holds the possibility of correction though gene therapy in the future. It is increasingly clear that many renal disorders in pediatrics are a consequence of genetic mutations. In the future, genetic testing will become as easy and as common as ordering a serum creatinine today.

Kidney Transplantation - New Developments

Swiss Surgery ◽  
2003 ◽  
Vol 9 (5) ◽  
pp. 205-212 ◽  
Author(s):  
Dahm ◽  
Weber
Keyword(s):  
Kidney Transplantation ◽  
Renal Disease ◽  
De Novo ◽  
Preoperative Assessment ◽  
Infectious Complications ◽  
Living Donation ◽  
Organ Shortage ◽  
Prophylactic Measures ◽  
Kidney Transplantations ◽  
Over Time

The standard of care for patients with end-stage renal disease is kidney transplantation, which not only confers a survival benefit compared to hemodialysis, but is also cost-effective. The indications, contraindications as well as the preoperative assessment of recipients are discussed. The recurrence rate of the underlying renal disease has to be taken into account, especially in living donation. Growing organ shortage has lead transplant surgeons to accept older, less healthy, and even non-heart-beating donors, with generally good results. Living-donation is safe for the donor, outcome is excellent and plays an increasing role today. It has surpassed the number of cadaveric kidney transplantations in some countries. Many centres now apply laparoscopic donor nephrectomy with low morbidity. Matching for ABO blood group and HLA is routinely performed, as well as pre-transplant crossmatching. The surgical procedure has been standardized and the complication rate is low. Immunosuppressive protocols have evolved over time, and while the optimal regimen has not been defined, the availability of numerous agents allows the regimen to be individualized. New agents are being introduced into clinical practice. With increasing long-term graft survival and thus life-long immunosuppression, cardiovascular disease, de-novo malignancies and infectious complications are major causes of morbidity and mortality of transplant recipients. Effective prophylactic measures are often available, and surveillance protocols are warranted in these patients. Overall, the outcome of renal transplantation is excellent and has improved over time. Future prospects include induction of allograft tolerance, tissue engineering and xenotransplantation.

scholarly journals The Change in Living Kidney Donation in Women and Men in the United States (2005–2015): A Population-Based Analysis

2018 ◽  
Vol 29 (4) ◽  
pp. 1301-1308 ◽  
Author(s):  
Jagbir Gill ◽  
Yayuk Joffres ◽  
Caren Rose ◽  
Julie Lesage ◽  
David Landsberg ◽  
...  
Keyword(s):  
United States ◽  
The United States ◽  
Population Based ◽  
Kidney Donation ◽  
Living Donation ◽  
Living Kidney Donation ◽  
United States Census ◽  
Longitudinal Changes ◽  
Using Data ◽  
Living Related

The factors underlying the decline in living kidney donation in the United States since 2005 must be understood to inform strategies to ensure access to this option for future patients. Population-based estimates provide a better assessment of donation activity than do trends in the number of living donor transplants. Using data from the Scientific Registry of Transplant Recipients and the United States Census, we determined longitudinal changes in living kidney donation between 2005 and 2015, focusing on the effect of sex and income. We used multilevel Poisson models to adjust for differences in age, race, the incidence of ESRD, and geographic factors (including population density, urbanization, and daily commuting). During the study period, the unadjusted rate of donation was 30.1 and 19.3 per million population in women and men, respectively, and the adjusted incidence of donation was 44% higher in women (incidence rate ratio [IRR], 1.44; 95% confidence interval [95% CI], 1.39 to 1.49). The incidence of donation was stable in women (IRR, 0.95; 95% CI, 0.84 to 1.07) but declined in men (IRR, 0.75; 95% CI, 0.68 to 0.83). Income was associated with longitudinal changes in donation in both sexes, yet donation was stable in the highest two population income quartiles in women but only in the highest income quartile in men. In both sexes, living related donations declined, irrespective of income. In conclusion, living donation declined in men but remained stable in women between 2005 and 2015, and income appeared to have a greater effect on living donation in men.

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