scholarly journals Graft function assessment in mouse models of single- and dual-kidney transplantation

2018 ◽  
Vol 315 (3) ◽  
pp. F628-F636 ◽  
Author(s):  
Lei Wang ◽  
Ximing Wang ◽  
Shan Jiang ◽  
Jin Wei ◽  
Jacentha Buggs ◽  
...  
Keyword(s):  
Kidney Transplantation ◽  
Animal Models ◽  
Survival Rates ◽  
Graft Function ◽  
Kidney Injury ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Additional Tool ◽  
Knockout Animal ◽  
Single Nephron

Animal models of kidney transplantation (KTX) are widely used in studying immune response of hosts to implanted grafts. Additionally, KTX can be used in generating kidney-specific knockout animal models by transplantation of kidneys from donors with global knockout of a gene to wild-type recipients or vice versa. Dual-kidney transplantation (DKT) provides a more physiological environment for recipients than single-kidney transplantation (SKT). However, DKT in mice is rare due to technical challenges. In this study, we successfully performed DKT in mice and compared the hemodynamic response and graft function with SKT. The surgical time, complications, and survival rate of DKT were not significantly different from SKT, where survival rates were above 85%. Mice with DKT showed less injury and quicker recovery with lower plasma creatinine (Pcr) and higher glomerular filtration rate (GFR) than SKT mice (Pcr = 0.34 and 0.17 mg/dl in DKT vs. 0.50 and 0.36 mg/dl in SKT at 1 and 3 days, respectively; GFR = 215 and 131 µl/min for DKT and SKT, respectively). In addition, the DKT exhibited better renal functional reserve and long-term outcome of renal graft function than SKT based on the response to acute volume expansion. In conclusion, we have successfully generated a mouse DKT model. The hemodynamic responses of DKT better mimic physiological situations with less kidney injury and better recovery than SKT because of reduced confounding factors such as single nephron hyperfiltration. We anticipate DKT in mice will provide an additional tool for evaluation of renal significance in physiology and disease.

Delayed Graft Function and Long-Term Outcome in Kidney Transplantation

2012 ◽  
Vol 44 (7) ◽  
pp. 1879-1883 ◽  
Author(s):  
G. Grosso ◽  
D. Corona ◽  
A. Mistretta ◽  
D. Zerbo ◽  
N. Sinagra ◽  
...  
Keyword(s):  
Kidney Transplantation ◽  
Graft Function ◽  
Delayed Graft Function ◽  
Term Outcome ◽  
Long Term Outcome

scholarly journals Prediction of Kidney Transplant Outcome Based On Different DGF Definitions In Chinese Deceased Donation

2019 ◽  
Author(s):  
Xiao-jun Hu ◽  
Jin Zheng ◽  
Yang Li ◽  
Xiao-hui Tian ◽  
Pu-xun Tian ◽  
...  
Keyword(s):  
Kidney Transplantation ◽  
Graft Loss ◽  
Graft Function ◽  
Reduction Rate ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Transplant Outcome ◽  
Transplantation Surgery ◽  
Relationship Of

Abstract Background Delayed graft function (DGF) is an important complication of kidney transplantation and can be diagnosed according to different definitions. DGF has been proven to be associated with the long-term outcome of kidney transplantation surgery. However, the best DGF definition for predicting renal transplant outcomes in Chinese donations after cardiac death (DCDs) remains to be determined. Method A total of 182 DCD kidney transplants from January 2015 to December 2015 in the First Affiliated Hospital of Xi’an Jiaotong University were diagnosed with DGF according to 6 different DGF definitions. The relationship of the DGF definitions to the three-year graft loss (GL) and 12-month estimated glomerular filtration rate (eGFR) posttransplantation was compared. Results The incidence of DGF varied from 5.01% to 50.89% according to the different DGF diagnoses. All DGF definitions were significantly associated with three-year GL and had considerable predictive power for a poorer transplant outcome. None of the DGF definitions were significantly better than the dialysis-based DGF definition. Conclusion DGF was a independent risk factor for poorer transplant outcome. In the Chinese DCD population, no definitions were superior to the universally accepted one, namely, the need for hemodialysis in the first week posttransplantation. Combination of need for hemodialysis within the first week and 48h serum creatinine reduction rate has a better predictive value for graft loss.

scholarly journals Histopathology and Long-Term Outcome of Kidneys Transplanted From Donors With Severe Acute Kidney Injury

2018 ◽  
Vol 29 (1) ◽  
pp. 36-42 ◽  
Author(s):  
Luca Cima ◽  
Francesco Nacchia ◽  
Claudio Ghimenton ◽  
Giovanni Valotto ◽  
Luigino Boschiero ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Kidney Transplantation ◽  
Acute Tubular Necrosis ◽  
Statistical Significance ◽  
Graft Function ◽  
Kidney Injury ◽  
Long Term Outcome ◽  
Tubular Necrosis ◽  
Level 3

Background: Acute kidney injury is a treatable entity although difficult to recognize without diagnostic biopsy. We investigated the potential association between clinically defined deceased donors and acute kidney injury with preimplantation histological findings and recipient outcomes. Methods: Kidney biopsies from donors were classified using the Acute Kidney Injury Network criteria and assessed for percentage glomerulosclerosis, tubular atrophy, interstitial fibrosis, and vascular narrowing with the Remuzzi score and for acute tubular necrosis. Differences in incidence rates of delayed graft function (DGF) and cumulative rejection episodes were compared between recipients transplanted with normal and 3 levels of acute kidney injury using the analysis of variance with Bonferroni correction ( P = .0012). Results: Sixteen out of 335 donors showed a severe acute kidney injury level 3 with a median serum creatinine of 458 µmol/L. Fourteen (88%) had 0-3 Remuzzi score and were used for single kidney transplantation and 2 (12%) were used for dual kidney transplantation (score: 4-6). Recipients who received a kidney from a donor with level 3 acute kidney injury had a higher percentage of DGF (47%) without statistical significance ( P = .008). The rate of cumulative rejection (45%) at 2 years was not significantly increased ( P = .09). Conclusions: Recipients receiving level 3 acute kidney injury kidneys, selected with Remuzzi histopathological score and acute tubular necrosis assessment, had a greater incidence of DGF but a similar long-term cumulative rejection compared to no injury and level 1 and level 2 acute kidney injury donors. The application of the histopathological examination allowed expansion of the kidney donor pool.

scholarly journals Poor early graft function impairs long-term outcome in living donor kidney transplantation

2012 ◽  
Vol 31 (4) ◽  
pp. 901-906 ◽  
Author(s):  
J. Hellegering ◽  
J. Visser ◽  
H. J. Kloke ◽  
F. C. H. D’Ancona ◽  
A. J. Hoitsma ◽  
...  
Keyword(s):  
Kidney Transplantation ◽  
Living Donor ◽  
Graft Function ◽  
Donor Kidney ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Early Graft ◽  
Donor Kidney Transplantation ◽  
Living Donor Kidney

scholarly journals Influence of Multiple Donor Renal Arteries on the Outcome and Graft Survival in Deceased Donor Kidney Transplantation

2021 ◽  
Vol 10 (19) ◽  
pp. 4395
Author(s):  
Uwe Scheuermann ◽  
Sebastian Rademacher ◽  
Tristan Wagner ◽  
Andri Lederer ◽  
Hans-Michael Hau ◽  
...  
Keyword(s):  
Kidney Transplantation ◽  
Renal Artery ◽  
Graft Survival ◽  
Graft Function ◽  
Deceased Donor ◽  
Renal Arteries ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Arterial Anastomosis

Aim: Complex arterial reconstruction in kidney transplantation (KT) using kidneys from deceased donors (DD) warrants additional study since little is known about the effects on the mid- and long-term outcome and graft survival. Methods: A total of 451 patients receiving deceased donor KT in our department between 1993 and 2017 were included in our study. Patients were divided into three groups according to the number of arteries and anastomosis: (A) 1 renal artery, 1 arterial anastomosis (N = 369); (B) >1 renal artery, 1 arterial anastomosis (N = 47); and (C) >1 renal artery, >1 arterial anastomosis (N = 35). Furthermore, the influence of localization of the arterial anastomosis (common iliac artery (CIA), versus non-CIA) was analyzed. Clinicopathological characteristics, outcome, and graft and patient survival of all groups were compared retrospectively. Results: With growing vascular complexity, the time of warm ischemia increased significantly (groups A, B, and C: 40 ± 19 min, 45 ± 19 min, and 50 ± 17 min, respectively; p = 0.006). Furthermore, the duration of operation was prolonged, although this did not reach significance (groups A, B, and C: 175 ± 98 min, 180 ± 35 min, and 210 ± 43 min, respectively; p = 0.352). There were no significant differences regarding surgical complications, post-transplant kidney function (delayed graft function, initial non-function, episodes of acute rejection), or long-term graft survival. Regarding the localization of the arterial anastomosis, non-CIA was an independent prognostic factor for deep vein thrombosis in multivariate analysis (CIA versus non-CIA: OR 11.551; 95% CI, 1.218–109.554; p = 0.033). Conclusion: Multiple-donor renal arteries should not be considered a contraindication to deceased KT, as morbidity rates and long-term outcomes seem to be comparable with grafts with single arteries and less complex anastomoses.

Perinatal Care at the Threshold of Viability

PEDIATRICS ◽  
1995 ◽  
Vol 96 (5) ◽  
pp. 974-976
Author(s):  
◽  
◽  
◽  
Keyword(s):  
Perinatal Care ◽  
Survival Rates ◽  
Extremely Low Birth Weight ◽  
Low Birth Weight Infants ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Obstetric Management ◽  
The Cost ◽  
The Impact

The survival rate for infants at the threshold of viability has been improving. However, there are insufficient data regarding the cost(s) of initial and ongoing care of these infants and the long-term outcome of survivors. Furthermore, there has been little study of the impact of obstetric management on the survival rates of extremely low birth weight infants and on long-term morbidities. Continued research on these issues is imperative, and physicians need to remain informed of changing statistics.

scholarly journals Predictors for the Immediate and Long-Term Outcome of Avascular Surgical Procedure

2009 ◽  
Vol 98 (3) ◽  
pp. 164-168 ◽  
Author(s):  
J. Virkkunen ◽  
M. Venermo ◽  
J. Saarinen ◽  
J. Salenius
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
High Risk ◽  
Predictive Value ◽  
Surgical Procedure ◽  
Operative Mortality ◽  
Survival Rates ◽  
Term Outcome ◽  
Long Term Outcome

Background and Aims: The ability to predict post-operative mortality reliably will be of assistance in making decisions concerning the treatment of an individual patient. The aim of this study was to test the GAS score as a predictor of post-operative mortality in vascular surgical patients. Material and Methods: A total of 157 consecutive patients who underwent an elective vascular surgical procedure were included in the study. The Cox proportional hazards model was used in analyzing the importance of various preoperative risk factors for the postoperative outcome. ASA and GAS were tested in predicting the short and long-term outcome. On the basis of the GAS cut-off value 77, patients were selected into low-risk (GAS low: GAS < 77) and high-risk (GAS high: GAS > = 77) groups, and the examined risk factors were analyzed to determine which of them had predictive value for the prognosis. Results: None of the patients in the GAS low group died, and mortality in the GAS high group was 4.8% (p = 0.03) at 30 days' follow-up. The 12-month survival rates were 98.6% and 78.6% (p = 0.0001), respectively, with the respective 5-year survival rates of 76.7% and 44.0% (p = 0.0001). The only independent risk factor for 30-day mortality was the renal risk factor (OR 20.2). The combination of all three GAS variables(chronic renal failure, cardiac disease and cerebrovascular disease), excluding age, was associated with a 100% two-year mortality. Conclusions: Mortality is low for patients with GAS<77. For the high-risk patients (GAS> = 77), due to its low predictive value for death, GAS yields limited value in clinical practice. In cases of patients with all three risk factors (renal, cardiac and cerebrovascular), vascular surgery should be considered very carefully.

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