Implications of renal transplantation on serum testosterone and preoperative factors affecting its levels in the post-transplant period

2021 ◽  
pp. 205141582110407
Author(s):  
Rohit Pratap Singh ◽  
Vinay Tomar ◽  
Sher Singh Yadav
Keyword(s):  
Renal Transplantation ◽  
Positive Impact ◽  
Graft Function ◽  
Human Leukocyte ◽  
Serum Testosterone ◽  
Level Of Evidence ◽  
Factors Affecting ◽  
Post Transplant ◽  
Testosterone Levels ◽  
Postoperative Serum

Objective: Low serum testosterone is highly prevalent in chronic kidney disease patients. The objective of the study was to determine levels of serum testosterone at the time of transplantation, the prevalence of testosterone deficiency/insufficiency in the pre- and post-transplant periods, and its correlation with patients’ age, serum creatinine, duration of preoperative dialysis, human leukocyte antigen (HLA) matching, and graft outcomes. Methods: The study was conducted from January 2019 to April 2020. Forty-five male renal transplant patients were evaluated before and at one and six months following transplant for changes in testosterone and creatinine levels. Six-month follow-up was possible for 28 patients. Result: Renal transplantation resulted in significant improvement in testosterone levels as early as one month after transplantation. The duration of preoperative dialysis and HLA match had a negative and positive impact on postoperative serum testosterone levels, respectively. We did not find any impact of testosterone levels on graft function. Conclusion: Successful transplantation among the study population produced a positive impact on serum testosterone levels. The duration of preoperative dialysis and HLA match had a negative and positive impact on postoperative serum testosterone levels, respectively. Level of evidence: XXX.

Effect of Pre-Transplant Dialysis Modality on Kidney Transplantation Outcome

2009 ◽  
Vol 29 (2_suppl) ◽  
pp. 117-122 ◽  
Author(s):  
Yasar Caliskan ◽  
Halil Yazici ◽  
Numan Gorgulu ◽  
Berna Yelken ◽  
Turker Emre ◽  
...  
Keyword(s):  
Renal Transplantation ◽  
Acute Rejection ◽  
Bacterial Infections ◽  
Graft Function ◽  
Human Leukocyte ◽  
Control Group ◽  
Dialysis Modality ◽  
Post Transplant ◽  
Early Graft ◽  
Cmv Disease

Background The effect of pre-transplant dialysis modality on early graft function is a matter of debate. Although some authors deny the existence of a significant influence, others suggest that peritoneal dialysis (PD) affects early graft function favorably, possibly by contributing to a more physiologic water balance. In the present study, we evaluated the influence of pre-transplant dialysis modality on early and late graft function. Patients and Methods We studied 745 patients who underwent a first renal transplantation during 1983 – 2006, comparing the records of 44 PD patients [26 male; mean age: 26 ± 9 years (range: 8 – 56 years)] who received 36 living related and 8 cadaveric renal transplantations with those of a control group of 44 consecutive hemodialysis (HD) patients [26 male; mean age: 27 ± 11 years (range: 7 – 49 years)] for the index cases. Results The groups showed no significant differences in donor type, human leukocyte antigen matching, immunosuppressive protocols, and duration of dialysis. Also, neither group differed significantly with regard to incidence of delayed graft function, acute tubular necrosis, wound infection, systemic viral and bacterial infections, or acute rejection in the early post-transplant period. In the late post-transplant period, incidences of chronic rejection, graft failure, and malignancies were also similar. During the follow-up period, 3 patients in the PD group experienced acute rejection, 2 developed cytomegalovirus (CMV) disease, and 5 developed various other infections. In the HD group, 4 patients experienced acute rejection, 1 developed CMV disease, and 8 experienced other infections. Five patients in the PD group and one in the HD group died with functioning grafts ( p = 0.09). No differences were noted between the groups in the incidences of post-transplant cardiovascular complications, malignancies, and diabetes mellitus. In the PD group, 33 patients with functioning grafts are still being followed, 6 have returned to dialysis, and 5 have died. In the HD group, 38 patients with functioning grafts are still being followed, 5 have returned to dialysis, and 1 has died. Conclusions As a pre-transplant dialysis modality, neither HD nor PD affects the outcome of renal transplantation.

scholarly journals A path to renal transplantation in Nepal

1970 ◽  
Vol 1 (1) ◽  
pp. 52-55
Author(s):  
J Enns ◽  
G Aryal
Keyword(s):  
Renal Transplantation ◽  
Renal Replacement Therapy ◽  
Human Leukocyte Antigen ◽  
Replacement Therapy ◽  
Human Leukocyte ◽  
Cost Effective ◽  
Leukocyte Antigen ◽  
Post Transplant ◽  
Stage Renal Disease ◽  
End Stage

End Stage Renal Disease affects many people in the world. There are three methods of renal replacement therapy available to patients: Continuous ambulatory peritoneal dialysis, haemodialysis and transplantation. Transplantation is the most viable and cost effective form of renal replacement therapy that is available for these patients. There are 3 factors required to help ensure a successful renal transplantation program: A well legislated donor and recipient program, Human Leukocyte Antigen testing (pre and post transplant), as well as a post transplant follow up program. Keywords: Renal Transplant; South Asia; Nepal; Human Leukocyte Antigen DOI: 10.3126/jpn.v1i1.4453 Journal of Pathology of Nepal (2011) Vol.1, 52-55

P1769POST TRANSPLANT MALIGNANCY - OUR EXPERIENCE

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
George Kurian ◽  
Gauri Shankar Jagadesh ◽  
Sandeep Sreedharan ◽  
Zachariah Paul ◽  
Anil Mathew ◽  
...  
Keyword(s):  
Renal Transplantation ◽  
Solid Organ ◽  
Oncogenic Viruses ◽  
Factors Affecting ◽  
Post Transplant ◽  
Transplant Patients ◽  
Cell Immunity ◽  
Number Of Patients ◽  
Increased Risk ◽  
Histological Variant

Abstract Background and Aims Cancer is now increasingly recognized as a major cause of death among patients especially after kidney transplantation. Malignancy represent a major burden in transplantation medicine. The Incidence is about 12 fold higher for PTLD and 3.5 fold higher for non-cutaneous malignancy compare to age-matched population. The increased risk is multifactorial and attributed to oncogenic viruses, immunosuppression and altered T cell immunity. In the era of longer graft survival and with the introduction of more potent immunosuppressive medication, malignancy represents a major burden. The incidence of malignancy after renal transplantation is 3 to 5 times higher. Incidence is higher in transplant patients even when compared to patients on hemodialysis. Aim: We attempted to assess the incidence of post-transplant malignancies in patients who underwent renal transplantation at our centre, along with studying the presentation, type and other factors affecting their development. Method We analysed data retrospectively from 626patients who underwent renal transplantation atour centre from January 2003 to September 2018.Pre transplant history, post transplant course including duration on hemodialysis, immunosuppression details and duration till diagnosis of malignancies were collected. Details regarding type of malignancy, histopathology, staging and treatment given and outcome were collected. Results Number of transplant recipient-626. The total number of patients with malignancy is 12. Incidence of malignancy posttransplant is 1.9%.Male-7 and female-6.One patient was detected with 2 malignanciesduring her post transplant period. The types of malignancies encountered were Conclusion The incidence of malignancy – 1.9%.Probable reason for decreased incidence of malignancy is the decreased immunosuppression needed by South Asian people. The most common malignancy was solid organ tumour; tongue being the most common organ. Most common histological variant is squamous cell carcinoma.Non-Hodgkin is more common than Hodgkin. Incidence of malignancy is low. Decision regarding cancer screening should be made on individual basis.

scholarly journals The Assessment of HLA Sensitization Effect on Graft Function and Survival in Renal Transplant Recipients

2021 ◽  
Author(s):  
Derya Güleç ◽  
Tülay Kılıçaslan Ayna ◽  
Mustafa Soyöz ◽  
İsmail Sert ◽  
Cem Tuğmen ◽  
...  
Keyword(s):  
Graft Survival ◽  
Cox Regression ◽  
Patient Survival ◽  
Graft Function ◽  
Human Leukocyte ◽  
Hla Class I ◽  
Acute Rejection Episode ◽  
Renal Transplant Recipients ◽  
Hla Antibodies ◽  
Post Transplant

Objective: Anti-human leukocyte antibodies (HLA) play an important role in graft survival, particularly in kidney transplantation. Preformed anti-HLA antibodies, especially donor specific antibodies can cause acute and chronic rejections. In this study, it was aimed to assess the effects of anti-HLA antibodies in kidney patients before transplant on graft function, failure, and patient survival. Methods: PRA (Panel Reactive Antibody) levels were monitored using bead based methods such as Luminex and flow cytometry. Post-transplant estimated glomerular filtration ratios (eGFR) among first, third, and fifth year patient survivals and graft failures were statistically analyzed. Results: In this study, it was observed that related transplants had low levels of PRAs, and their eGFRs were at normal reference range. The patients without acute rejection episode (ARE) had higher eGFR values than those with ARE. When five year-graft survival terms were evaluated, it was found that 65.6±9.8% and 86.5±3.2% graft survival terms were detected in anti-HLA Class I/II positive and negative patients, whereas 74.8±6.4% and 84.3 ±2.6% graft survival terms were observed in ARE positive and negative patients, respectively. eGFR value is a predictor of graft failure and patient survival. Our Cox regression analyses (HR=0.843, p=0.00) also supported this information. Conclusion: The study concluded that although the correlation between PRA positivity and graft survival were not significant, the shortest graft survival was observed in PRA positive patients in the whole cohort and ARE positive patients. The importance and requirement of pre- and post-transplant PRA tests continue.

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 Peritoneal dialysis catheter removal at the time of renal transplantation: Choosing the optimal candidate

2019 ◽  
Vol 14 (1) ◽  
Author(s):  
Jethro C.C. Kwong ◽  
Tad Kroczak ◽  
John R. D'A Honey ◽  
Robert J. Stewart ◽  
Kenneth T. Pace ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Renal Transplantation ◽  
Primary Outcome ◽  
Graft Function ◽  
Catheter Removal ◽  
Complication Rates ◽  
Peritoneal Dialysis Catheter ◽  
Related Complication ◽  
Post Transplant ◽  
Urine Production

Introduction: Concurrent peritoneal dialysis (PD) catheter removal during renal transplantation is controversial, with limited evidence supporting this practice. Our objective was to determine the rate of delayed graft function (DGF) in patients on preoperative PD. Additionally, we sought to identify which patients can safely have their PD catheter removed during transplantation due to a low risk of DGF. Methods: We conducted a retrospective observational study between June 2011 and December 2015. The primary outcome was the diagnosis of DGF, defined as the need for dialysis within the first week of transplantation. Clinical and transplant factors, including graft type and donor criteria, were assessed for association with the primary outcome. Catheter-related complication rates were also compared between post-transplant PD and hemodialysis (HD). Results: Of our cohort of 567 patients, 145 patients (25.6%) developed DGF. Obesity (odds ratio [OR] 1.06; 95% confidence interval [CI] 1.00–1.11; p=0.04) and increased perioperative blood loss (OR 1.002; 95% CI 1.000–1.003; p=0.03) were predictors of DGF. Protective factors included living donor (LD) grafts (OR 0.15; 95% CI 0.05–0.49; p=0.002) and intraoperative graft urine production (OR 0.39; 95% CI 0.23–0.65; p<0.001). In our PD cohort, only LD grafts demonstrated lower DGF rates (0 LD vs. 20.8% deceased donor; p=0.003). In terms of post-transplant renal replacement therapy, patients on PD and HD had similar duration of temporary dialysis (one day PD vs. two days HD; p=0.48) and catheter-related complication rates (4.5% PD vs. 2.6% HD; p=0.30). Conclusions: Carefully selected patients, such as those receiving LD grafts, may benefit from concurrent PD catheter removal.

scholarly journals Should peritoneal dialysis catheters be removed at the time of kidney transplantation?

2012 ◽  
Vol 6 (5) ◽  
Author(s):  
Jeff Warren ◽  
Emily Jones ◽  
Alp Sener ◽  
Martin Drage ◽  
Ali Taqi ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Kidney Transplantation ◽  
Renal Transplantation ◽  
Graft Function ◽  
Delayed Graft Function ◽  
Catheter Removal ◽  
Complication Rates ◽  
Failure Rates ◽  
Post Transplant

Background: Delayed graft function (DGF) following transplantationnecessitates support in the form of hemodialyis (HD) orperitoneal dialysis (PD). However, post-transplant PD-related complicationand failure rates are unknown.Methods: We studies patients who were on PD at the time of kidneytransplantation over a 4-year period at two separate institutions.Results: Of the 137 PD patients, 19 had their catheters removedat the time of transplant. Of the remaining 118 patients, 89% hadimmediate graft function. PD-related complications in this groupincluded peritonitis (n=5), catheter-related infections (n=2) andemergency laparotomy (n=1). Of the 15 patients requiring posttransplantPD, 33% developed peritonitis and 20% had fluid-leaksnecessitating HD. Overall, leaving a PD catheter in situ post- transplantationis associated with 7% rate of peritonitis versus 0% ifremoved (p < 0.05).Conclusions: PD catheter removal should be considered at thetime of renal transplantation, as postoperative PD-related failure/complication rates are high.

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