The Impact of Virtual Crossmatch on Cold Ischemic Times and Outcomes Following Kidney Transplantation

2020 ◽  
pp. 000313482094218
Author(s):  
Sadaf Aslam ◽  
Jacentha Buggs ◽  
Kasey Wyatt ◽  
Ambuj Kumar ◽  
Ebonie Rogers ◽  
...  
Keyword(s):  
Kidney Transplantation ◽  
Small Sample Size ◽  
Graft Function ◽  
Human Leukocyte ◽  
Small Sample ◽  
Donor Pool ◽  
Ischemic Time ◽  
Post Transplant ◽  
Cold Ischemic Time ◽  
The Impact

Background Prolonged cold ischemic time (CIT) in deceased donor kidney transplantation (DDKT) has been associated with adverse graft outcomes. Virtual crossmatch (VXM) facilitates reliable prediction of crossmatch results based on the profile of human leukocyte antigen antibodies of the recipient and the donor in reduced time compared with a physical crossmatch (PXM). We hypothesized a shorter CIT since the implementation of the VXM in recipients of DDKT. Methods We conducted a retrospective cohort study of consecutive adult recipients of DDKT. The data were analyzed for differences in CIT before and after the implementation of VXM. Results After the exclusion of 59 recipients (age less than 18 years and/or CIT ≥ 20 hours), our study compared outcomes of 81 PXMs from February to June 2018 against 68 VXMs from February to June 2019. There were no statistical differences between groups based on donor age ( P = .09), donor type ( P = .38), kidney donor profile index ( P = .43), or delayed graft function ( P = .20). Recipients with VXM were older (58 vs 51 years , P = .002) and had a higher estimated post-transplant survival score (59% vs 46% , P = .01). The CIT was significantly lower for the VXM group ( P = .04). Conclusion Our study demonstrated a significantly shorter CIT with VXM in DDKT recipients. Our study was limited with small sample size, but the trend of increased graft survival with higher estimated post-transplant scores and older recipients is encouraging as the donor pool expands with marginal kidneys and national sharing.

scholarly journals Kidney transplant outcomes after medical assistance in dying

2021 ◽  
Vol 16 (2) ◽  
Author(s):  
Patrick P. Luke ◽  
Anton Skaro ◽  
Alp Sener ◽  
Ephraim Tang ◽  
Max Levine ◽  
...  
Keyword(s):  
Kidney Transplantation ◽  
Large Scale ◽  
Graft Function ◽  
Delayed Graft Function ◽  
Medical Assistance ◽  
Ischemic Time ◽  
Transplant Outcomes ◽  
Medical Assistance In Dying ◽  
Cold Ischemic Time ◽  
The Mean

Introduction: After nearly four years of Canadian experience with medical assistance in dying (MAiD), the clinical volume of organ transplantation following MAiD remains low. This is the first Canadian report evaluating recipient outcomes from kidney transplantation following MAiD. Methods: This was a retrospective review of the first nine cases of kidney transplants following MAiD at a Canadian transplant center. Results: Nine patients underwent MAiD followed by kidney retrieval during the study period. Their diagnoses were largely neuromuscular diseases. The mean warm ischemic time was 20 minutes (standard deviation [SD] 7). The nine recipients had a mean age of 60 (SD 19.7). The mean cold ischemic time was 525 minutes (SD 126). Delayed graft function occurred in only one patient out of nine. The mean 30-day creatinine was 124 umol/L (SD 52) . The mean three-month creatinine was 115 umol/L (SD 29). Conclusions: We report nine cases of kidney transplantation following MAiD. The process minimized warm ischemia, resulting in low delayed graft function rates, and acceptable post-transplant outcomes. Further large-scale research is necessary to optimize processes and outcomes in this novel clinical pathway.

scholarly journals Assessment of risk factors for hospital readmission after kidney transplantation

2021 ◽  
Author(s):  
Mahmoud Tavakkoli ◽  
Amir Yarahmadi ◽  
Mahin Ghorban Sabbagh ◽  
Mona Najaf Najafi ◽  
Milad Tavakoli ◽  
...  
Keyword(s):  
Risk Factors ◽  
Kidney Transplantation ◽  
Hospital Readmission ◽  
Intraoperative Complications ◽  
Demographic Data ◽  
Graft Function ◽  
Delayed Graft Function ◽  
Post Discharge ◽  
Ischemic Time ◽  
Cold Ischemic Time

Background and Purpose: Hospital readmission after kidney transplantation is a real challenge for both patients and healthcare systems. Assessment of the risk factors of readmission after kidney transplantation is vital and can reduce morbidity and cost in transplant recipients and donors. The aim of the current study was to determine the risk factors of hospital readmission in patients undergoing kidney transplantation in Montaserieh Hospital of Mashhad, northeast of Iran. Materials and Methods: This retrospective study included 523 first kidney transplant patients between January 2013 and March 2019 from the Montaserieh Hospital Information System (HIS) of Mashhad, Iran. Every-time readmission was the study primary outcome. Donors and recipient's demographic data, recipient's comorbidities, reasons for end-stage renal disease (ESRD), panel reactive antibody (PRA) status, dialysis parameters, cold ischemic time, and delayed graft function (DGF) were the potential risk factors. Statistical analysis was done using Chi-square and Student's t-test. Results: Data from 523 patients were assessed for potential eligibility. Based on the exclusion criteria, data from 479 patients were included in the final analysis. 174 (36.3%) patients were never readmitted, and 305 (63.7%) were readmitted at least once post-discharge. 39 (12.8%) were readmitted within the first-month post-discharge. Older age, sex, higher prevalence of comorbidities, diabetes and hypertension, duration of primary disease before transplantation, hemodialysis and duration of pre-transplant dialysis, mean pre-transplant platelet count, intraoperative complications, increased cold ischemic time, and delayed graft function were associated with a higher prevalence of readmission (p<0.05). Conclusion Our results showed that different independent variables and patients' comorbidities were important risk factors for readmission after kidney transplantation. Early prediction of these risk factors could result in prevention from readmission in patients undergoing kidney transplantation.

scholarly journals Hubungan antara Total Waktu Iskemik pada Transplan Ginjal dengan Lama Perawatan di Rumah Sakit: A Single Center Report

2020 ◽  
Vol 7 (1) ◽  
pp. 41-45
Author(s):  
Eriawan Agung Nugroho ◽  
Muhamad Azwin Kamar ◽  
Ardy Santosa ◽  
Nanda Daniswara ◽  
Sofyan Rais Addin
Keyword(s):  
Kidney Transplantation ◽  
Graft Function ◽  
Delay Graft Function ◽  
Therapeutic Modality ◽  
Ischemic Time ◽  
Warm Ischemic Time ◽  
Cold Ischemic Time ◽  
Hospitalization Time ◽  
End Stage ◽  
Spearman Test

Latar Belakang : Transplantasi ginjal diakui sebagai kemajuan utama pengobatan modern yang memberikan kehidupan berkualitas tinggi kepada pasien penyakit ginjal stadium akhir (End Stage Renal Disease). Waktu iskemik dingin /Cold Ischemic Time (CIT) telah ditemukan sebagai faktor risiko independen yang penting untuk delay graft function (DGF) pada transplantasi ginjal. Terdapat informasi terbaru bahwa waktu iskemik hangat /Warm Ischemic Time (WIT) yang lama dapat mengurangi kelangsungan hidup graft dalam donor hidup transplantasi ginjal. Tujuan dari penelitian ini adalah untuk mengevaluasi hubungan total ischemik time selama operasi penerima dengan lama rawat inap. Metode : Penelitian ini merupkaan studi observational-cross sectional. Data didapatkan dari catatan medis pasien yang telah menjalani transplantasi ginjal dari Januari 2014 – Desember 2018 du RS Umum dr. Kariadi semarang. Terdapat 28 pasien, 18 diantaranya adalah laki-laki dan 10 adalah wanita. Data total waktu iskemik dibandingkan dengan lamanya rawat inap. Data dianalisa dengan tes Spearman menggunakan software SPSS versi 23. Hasil : Pada studi ini menunjukkan adanya korelasi yang signifikan antara total waktu iskemik dengan lama perawatan di rumah sakit (p<0.001). Akan tetapi, umur donor tidak mempengaruhi total waktu iskemik (p=0.673), tidak signifikan (signifikan jika p<0.005). Simpulan : Adanya hubungan yang signifikan antara total waktu iskemik dengan lama perawatan rumah sakit. Namun, tidak ditemukannya hubungan yang signifikan pada usia donor dan total waktu iskemik. Kata kunci: total waktu iskemik, lama perawatan, transplantasi ginjal   Background: Kidney transplantation is recognized as an advanced modern therapeutic modality, providing a better life for patients with end stage renal failure globally. Cold Ischemic Time (CIT) has been found as an important independent risk factor for delay graft function (DGF) in kidney transplantation. DGF also associated with patient’s survival post-operatively. Recent studies suggested that prolonged Warm Ischemic Time (WIT) may decrease graft’s survival in living kidney transplantation donor. This study aimed to evaluate the total ischemic time during recipient surgery and accessed its contribution for hospitalization time in kidney transplantation patients. Methods: This is a descriptive retrospective study. This study was started in 2014 until December 2018, including data from patients’ medical record whom underwent kidney transplantation in Kariadi General Hospital Semarang. Data was collected from 28 patients, including 18 male patients and 10 female patients. The author found a significant correlation between patient’s age and total ischemic time. Total ischemic time also compared with hospitalization time. Data was processed using Spearman test in SPSS software. Results: Based on Spearman test, Total ischemic time was significantly correlated with hospitalization time (p < 0.001). However, donor’s age did not affect prolonged total ischemic time with p = 0.673, which is not significant (significant if p value < 0.05). Conclusion: Total ischemic time has a significant correlation with hospitalization time. In contrary, no significant correlation between donor’s age and prolonged total ischemic time. Key Words: Total ischemic time, hospitalization time, kidney transplantation

scholarly journals Correlation of Warm and Cold Ischemic Time to Graft Function in Kidney Transplant: A Single Centre Report

2019 ◽  
Vol 12 (1) ◽  
pp. 66-71
Author(s):  
Eriawan A. Nugroho ◽  
Arif Hidayat ◽  
Ahsanu T. Hidayat
Keyword(s):  
Kidney Transplantation ◽  
Hypothesis Test ◽  
Pearson Correlation ◽  
Graft Function ◽  
Ischemic Time ◽  
Cold Ischemic Time ◽  
A Value ◽  
Life Years ◽  
Quality Life ◽  
Urine Production

Background: Kidney transplantation has been known as a major advancement of modern medicine which provides high-quality life years to patients with irreversible kidney failure (end-stage renal disease, ESRD) worldwide. The first kidney transplantation in Semarang was carried out at Telogorejo Hospital in 1985. Dr. Kariadi Hospital, has also undertaken kidney transplantation 28 times since January 2014 until September 2018. Kidney ischemic time is one of the most important factors which can affect the outcome of kidney transplantation. Prolonged ischemia of the graft can be related to transplantation’s effects. This study aimed to evaluate the influence of warm and cold ischemic time on the outcome of kidney transplantation in Dr. Kariadi Hospital Semarang. Material and Methods: This is an observational, cross-sectional study. The data was collected from medical record of all patients who underwent kidney transplantation from January 2014 until December 2018 and the level of creatinine and urine production before and after transplantation was documented. A total of 28 patients were registered and completed the inclusion criteria. The results of the study were tabulated and statistical analysis was performed using SPSS 23.0. The relationship was declared meaningful if p = 0.05 was obtained. Result: From the analysis of the research that has been done using the Pearson correlation test and hypothesis test Wilcoxon, it was found that there was a relationship between ischemic time and a decrease in creatinine level from r = -0.4489 with a value of p = 0.008. From the analysis of the research, a relationship between ischemic time and urine production was found after transplantation with a value of r = -0.562 and a value of p = 0.002. Conclusion: The results of this study show a strong correlation between the length of total ischemic time with a decrease in creatinine and urine production which means that the longer ischemic time, the lower the decrease in creatinine levels and the lesser the urine production.

scholarly journals Outcomes and factors leading to graft failure in kidney transplants from deceased donors with acute kidney injury—A retrospective cohort study

PLoS ONE ◽  
2021 ◽  
Vol 16 (8) ◽  
pp. e0254115
Author(s):  
Cheol Woong Jung ◽  
Dana Jorgensen ◽  
Puneet Sood ◽  
Rajil Mehta ◽  
Michele Molinari ◽  
...  
Keyword(s):  
Risk Factors ◽  
Acute Kidney Injury ◽  
Graft Failure ◽  
Graft Function ◽  
Kidney Injury ◽  
The United States ◽  
Kidney Transplants ◽  
Ischemic Time ◽  
Cold Ischemic Time ◽  
The Impact

Due to shortage of donor, kidney transplants (KTs) from donors with acute kidney injury (AKI) are expanding. Although previous studies comparing clinical outcomes between AKI and non-AKI donors in KTs have shown comparable results, data on high-volume analysis of KTs outcomes with AKI donors are limited. This study aimed to analyze the selection trends of AKI donors and investigate the impact of AKI on graft failure using the United states cohort data. We analyzed a total 52,757 KTs collected in the Scientific Registry of Transplant Recipient (SRTR) from 2010 to 2015. The sample included 4,962 (9.4%) cases of KTs with AKI donors (creatinine ≥ 2 mg/dL). Clinical characteristics of AKI and non-AKI donors were analyzed and outcomes of both groups were compared. We also analyzed risk factors for graft failure in AKI donor KTs. Although the incidence of delayed graft function was higher in recipients of AKI donors compared to non-AKI donors, graft and patient survival were not significantly different between the two groups. We found donor hypertension, cold ischemic time, the proportion of African American donors, and high KDPI were risk factors for graft failure in AKI donor KTs. KTs from deceased donor with AKI showed comparable outcomes. Thus, donors with AKI need to be considered more actively to expand donor pool. Caution is still needed when donors have additional risk factors of graft failure.

An influence of social isolation on the level of physical activity as well as on well-being and mental state of people during the coronavirus COVID-19 pandemic

2019 ◽  
Vol 129 (4) ◽  
pp. 127-131
Author(s):  
Agnieszka Parfin ◽  
Krystian Wdowiak ◽  
Marzena Furtak-Niczyporuk ◽  
Jolanta Herda
Keyword(s):  
Physical Activity ◽  
Social Isolation ◽  
Small Sample Size ◽  
Statistical Tests ◽  
Population Group ◽  
Well Being ◽  
Small Sample ◽  
Subjective Well Being ◽  
Tract Infections ◽  
The Impact

AbstractIntroduction. The COVID-19 is the name of an infectious disease caused by a new strain of coronavirus SARS-CoV-2 (Severe Acute Respiratory Syndrome Coronavirus 2). It was first diagnosed in December 2019 in patients in Wuhan City, Hubei Province, China. The symptoms are dominated by features of respiratory tract infections, in some patients with a very severe course leading to respiratory failure and, in extreme cases to death. Due to the spread of the infection worldwide, the WHO declared a pandemic in March 2020.Aim. An investigation of the impact of social isolation introduced due to the coronavirus pandemic on selected aspects of life. The researchers focused on observing changes in habits related to physical activity and their connections with people’s subjective well-being and emotional state.Material and methods. The study was carried out within the international project of the group „IRG on COVID and exercise”. The research tool was a standardized questionnaire.Results. Based on the data collected and the analysis of the percentage results, it can be observed that the overwhelming majority of people taking up physical activity reported a better mood during the pandemic. However, statistical tests do not confirm these relationships due to the small sample size.Conclusions. Isolation favours physical activity. Future, in-depth studies, by enlarging the population group, are necessary to confirm the above observations.

scholarly journals The Role of Dopamine Receptor D2 in Bridging the Intention-Behavior Gap in Sport Participation

2021 ◽  
Vol 18 (5) ◽  
pp. 2379
Author(s):  
Seiyeong Park ◽  
Junhye Kwon ◽  
Chiyoung Ahn ◽  
Hae-Sung Cho ◽  
Hyo Youl Moon ◽  
...  
Keyword(s):  
University Students ◽  
Dopamine Receptor ◽  
Sport Participation ◽  
Small Sample Size ◽  
Behavioral Model ◽  
Small Sample ◽  
Male Students ◽  
Future Research ◽  
Dopamine Receptor D2 ◽  
The Impact

Previous studies have identified that a behavior can occur through the strongest predictor intention, but there is a gap between intention and behavior. Dopamine receptor D2 (DRD2) is known to account for a variance in sporting behaviors in human and animal subjects. However, the relationship between DRD2 and sport participation has been poorly studied, and the limited available reports are inconsistent. The present study was performed to examine the impact of DRD2 on sport participation among Korean university students based on the integrated behavioral model (IBM). Data were collected from enrolled university students in Seoul (N = 45). Participants answered survey questions first, and then they gave investigators their hair to provide DNA information (i.e., the A1 allele of DRD2). DRD2 had a significant effect on sport participation, but only in male students. Male students who carried the A1 allele of DRD2 significantly participated in 105.10 min more sporting activities than male students who did not. Moreover, the effect of intention on sport participation was significantly decreased when considering DRD2. Despite the small sample size, the results of this study could be a preliminary case for a larger study and indicate the direction of future research. Our results suggest that DRD2 may have played an important role as the “actual skill” shown in the IBM.

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