scholarly journals Osteoarthritis-Related Knee Pain Treated With Genicular Artery Embolization: A Systematic Review and Meta-analysis

2021 ◽  
Vol 9 (7) ◽  
pp. 232596712110213
Author(s):  
Pooya Torkian ◽  
Jafar Golzarian ◽  
Majid Chalian ◽  
Alexander Clayton ◽  
Shahram Rahimi-Dehgolan ◽  
...  
Keyword(s):  
Systematic Review ◽  
Polyvinyl Alcohol ◽  
Knee Pain ◽  
Pain Medication ◽  
Current Evidence ◽  
Artery Embolization ◽  
Knee Oa ◽  
Number Of Patients ◽  
Significant Difference ◽  
Genicular Artery

Background: Genicular artery embolization (GAE) is an innovative technique that has been investigated as a supplementary treatment method for chronic pain secondary to knee osteoarthritis (OA). Purpose: To evaluate the current evidence on the effectiveness and safety of GAE for OA-related knee pain. Study Design: Systematic review; Level of evidence, 4. Methods: A systematic literature search was conducted in the PubMed, Web of Science, EMBASE, and Scopus databases to identify studies related to knee OA treated with GAE. Treatment agents were categorized as Embozene, imipenem/cilastatin, resorbable microspheres, and polyvinyl alcohol. The main outcomes were the mean difference (MD) in pre- and postembolization pain based on the visual analog scale (VAS) or the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scores as well as changes in the need for pain medication. Random- and fixed-effects models were applied for data analysis. Results: Of 379 initially inspected publications, 11 (N = 225 patients; 268 knees) were included in the final review. The quality of the studies was fair in 8 and poor in 3—categorized according to the National Institutes of Health quality assessment tool. Overall, 119, 72, 13, and 21 patients were treated with imipenem/cilastatin, Embozene, resorbable microspheres, and polyvinyl alcohol, respectively. Symptomatic improvement was reported in all studies. The pooled effect size, characterized by MD, showed a significant improvement in the VAS and WOMAC pain scores, with better functional status after GAE. Pre- versus postembolization MDs in VAS scores ranged from 32 within the first week to 58 after a 2-year follow-up (equivalent to 54% and 80% improvement, respectively). There was a similar trend in the overall WOMAC scores, with MDs ranging from 28.4 to 36.8 (about 58% and 85% improvement, respectively). GAE resulted in a decreased need for pain medication for knee OA, with a 27%, 65%, and 73% decline in the number of patients who used opioids, nonsteroidal anti-inflammatory drugs, and intra-articular hyaluronic acid injection, respectively ( P < .00001 for all). No significant difference between embolic agents was seen with regard to post-GAE pain reduction. No severe or life-threatening complications were reported. Conclusion: OA treated by GAE using different embolic particles can be considered generally safe, with good efficacy and no reported serious complications.

scholarly journals FRI0382 EFFECTS OF GENICULAR NERVE BLOCK IN PATIENTS WITH KNEE OSTEOARTHRITIS WHO HAVE NEUROPATHIC OR NOCICEPTIVE PAIN

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 788.2-789
Author(s):  
B. Tas ◽  
P. Akpinar ◽  
I. Aktas ◽  
F. Unlu Ozkan ◽  
I. B. Kurucu
Keyword(s):  
Neuropathic Pain ◽  
Knee Osteoarthritis ◽  
Nerve Block ◽  
Intractable Pain ◽  
Ultrasound Guided ◽  
Lidocaine Group ◽  
Knee Oa ◽  
Significant Difference ◽  
Genicular Artery ◽  
Saline Solutions

Background:Genicular nerve block (GNB) is a safe and effective therapeutic procedure for intractable pain associated with chronic knee osteoarthritis (OA)(1). There is increasing support for the neuropathic component to the knee OA pain. Investigators proposed that targeting treatment to the underlying pain mechanism can improve pain management in knee OA (2). There is a debate on injectable solutions used in nerve blocks (3).Objectives:To investigate the analgesic and functional effects of USG-guided GNB in patients with chronic knee OA (with/without neuropathic pain) and to evaluate the efficacy of the anesthetic and non-anesthetic solutions used.Methods:Ninety patients with chronic knee OA between the ages of 50-80 were divided into two groups with and without neuropathic pain according to painDETECT questionnaire (4). The groups were randomized into three subgroups to either the lidocaine group (n=30) or dextrose group (n=29) or saline solutions (n=31). After the ultrasound-guided GNB, quadriceps isometric strengthening exercises and cryotherapy were recommended to the patients. Visual analog scale (VAS), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and Lequesne-algofunctional Index were assessed at baseline and at 1 week, 1 and 3 months later after the procedure.Results:Statistically significant improvement was observed in all groups with or without neuropathic pain according to VAS values at the 1stweek, 1stmonth and 3rdmonth compared to baseline (p<0.05). Statistically significant improvement was observed in all groups with neuropathic pain according to painDETECT values at the 1stweek, 1stmonth and 3rdmonth compared to baseline (p<0.05). There was a statistically significant improvement in the groups without neuropathic pain which received dextrose and saline solutions, according to painDETECT values, but not in the group which received lidocain at the 1stweek, 1stmonth and 3rdmonth compared to baseline (p>0.05). There was a statistically significant improvement in all groups with or without neuropathic pain according to WOMAC and Lequesne total scores at the 1stweek, 1stmonth and 3rdmonth compared to baseline (p<0.05).Conclusion:We conclude that in patients with chronic knee OA (with/without neuropathic pain), the use of GNB with USG is an analgesic method which provides short to medium term analgesia and functional recovery and has no serious side effects. The lack of significant difference between the anesthetic and non-anesthetic solutions used in the GNB suggests that this may be a central effect rather than a symptom of peripheral nerve dysfunction. It suggests that injection may have an indirect effect through nociceptive processing and changes in neuroplastic mechanisms in the brain. In addition, we can say that regular exercise program contributes to improved physical function with the decrease in pain.References:[1]Kim DH et al. Ultrasound-guided genicular nerve block for knee osteoarthritis: a double-blind, randomized controlled trial of local anesthetic alone or in combination with corticosteroid. Pain Physician 2018;21:41-51.[2]Thakur M et.al. Osteoarthritis pain: nociceptive or neuropathic?. Nat Rev Rheumatol 2014:10(6):374.[3]Lam SKH et al. Transition from deep regional blocks toward deep nerve hydrodissection in the upper body and torso: method description and results from a retrospective chart review. BioMed Research International Volume 2017;7920438.[4]Hochman JR et al. Neuropathic pain symptoms in a community knee OA cohort. Osteoarthritis Cartilage. 2011 Jun;19(6):647-54.Fig. 1:Ultrasound- guided identification of GNB target sites. Doppler mode. White arrows indicate genicular arteries.A.Superior medial genicular artery.B.Inferior medial genicular artery.C.Superior lateral genicular artery.Disclosure of Interests:None declared

scholarly journals Kinesio Taping for Balance Function after Stroke: A Systematic Review and Meta-Analysis

2019 ◽  
Vol 2019 ◽  
pp. 1-15 ◽  
Author(s):  
Yijuan Hu ◽  
Dongling Zhong ◽  
Qiwei Xiao ◽  
Qiang Chen ◽  
Juan Li ◽  
...  
Keyword(s):  
Systematic Review ◽  
Treatment Duration ◽  
Meta Analysis ◽  
Current Evidence ◽  
Cochrane Library ◽  
Clinical Effects ◽  
Balance Function ◽  
Balance Impairment ◽  
Kinesio Taping ◽  
Significant Difference

Objective. With the increasing social and economic burdens of balance impairment after stroke, the treatment for balance impairment after stroke becomes a major public health problem worldwide. Kinesio taping (KT) as a part of clinical practice has been used widely in the treatment of balance impairment after stroke. However, the clinical effects of KT for balance function have not been confirmed. The objective of this study is to investigate the effects and safety of KT for balance impairment after stroke. Methods. We conducted a systematic review (SR) and meta-analysis of randomized controlled trials (RCTs) on the effects of KT for balance impairment after stroke. We searched the following databases: (1) English databases: EMBASE (via Ovid), MEDLINE (via Ovid), the Cochrane library, PubMed, and PEDro; (2) Chinese databases: China Biology Medicine (CBM), Wan Fang database, China National Knowledge Infrastructure (CNKI), and VIP. Besides, hand searches of relevant references were also conducted. We systematically searched from the inception to December 2018, using the keywords (Kinesio, Kinesio Tape, tape, or Orthotic Tape) and (stroke, hemiplegia, or hemiplegic paralysis) and (balance or stability). The search strategies were adjusted for each database. The reference lists of included articles were reviewed for relevant trials. For missing data, we contacted the authors to get additional information. Results. 22 RCTs involved 1331 patients, among which 667 patients in the experimental group and 664 patients in the control group were included. Results of meta-analysis showed that, compared with conventional rehabilitation (CR), there was significant difference in Berg Balance Scale (BBS) (MD=4.46, 95%CI 1.72 to 7.19, P=0.001), Time Up and Go Test (TUGT) (MD=-4.62, 95%CI -5.48 to -3.79, P < 0.00001), functional ambulation category scale (FAC) (MD=0.53, 95%CI 0.38 to 0.68, P < 0.00001), Fugl-Meyer assessment (FMA-L) (MD=4.20, 95%CI 3.17 to 5.24, P < 0.00001), and Modified Ashworth Scale (MAS) (MD=-0.38, 95%CI -0.49 to -0.27, P < 0.00001). The results of subgroup analysis showed that there was no significant difference between KT and CR with ≤4 weeks treatment duration (< 4 weeks: MD=5.03, 95%CI -1.80 to 11.85, P=0.15; =4 weeks: MD=4.33, 95%CI -1.50 to 10.15, P=0.15), while there was significant difference with more than 4-week treatment duration (MD=4.77, 95%CI 2.58 to 6.97, P < 0.0001). Conclusions. Based on current evidence, KT was more effective than CR for balance function, lower limb function, and walking function in poststroke patients. Longer treatment duration may be associated with better effects. However, more well-conducted RCTs are required in the future.

scholarly journals Eye Acupuncture Treatment for Stroke: A Systematic Review and Meta-Analysis

2015 ◽  
Vol 2015 ◽  
pp. 1-11 ◽  
Author(s):  
Zeng-Hua Bai ◽  
Zhi-Xing Zhang ◽  
Chun-Ri Li ◽  
Mei Wang ◽  
Meong-Ju Kim ◽  
...  
Keyword(s):  
Systematic Review ◽  
Randomized Controlled Trials ◽  
Western Medicine ◽  
Current Evidence ◽  
Effect Estimate ◽  
Controlled Trials ◽  
Search Activity ◽  
Randomized Controlled ◽  
Significant Difference ◽  
Eye Acupuncture

There were applications of eye acupuncture for stroke patients. Unfortunately, similar to many other Traditional Chinese Medicine (TCM) treatments, it lacks comprehensive evaluation and system review for its effect and safety.Objective. This study is a systematic review to appraise the safety and effectiveness of eye acupuncture for stroke.Methods. “Eye acupuncture therapy” in eleven databases was searched by randomized controlled trials and quasi-randomized controlled trials. The search activity was ended in April 2014. The data were extracted and assessed by three independent authors. Rev Man 5.0 software was used for data analysis with effect estimate presented as relative risk (RR) and mean difference (MD) with a 95% confidence interval.Results. Sixteen trials (1120 patients) were involved with generally poor methodological quality. The study indicated that when eye acupuncture was combined with western medicine compared to western medicine, there was a significant difference in the areas of mental state, swallow function, and NDS. When eye acupuncture was combined with western medicine and rehabilitation compared to western medicine and rehabilitation, there was significant difference in the changes of SSS, FMA, and constipation symptoms evaluation. No adverse events or side effects have been reported.Conclusions. The current evidence is insufficient and the rigorously designed trials are warranted.

scholarly journals Effectiveness and safety of inpatient versus extended venous thromboembolism (VTE) prophylaxis with heparin following major pelvic surgery for malignancy: protocol for a systematic review

2019 ◽  
Vol 8 (1) ◽  
Author(s):  
Bridget Heijkoop ◽  
Natalie Parker ◽  
George Kiroff ◽  
Daniel Spernat
Keyword(s):  
Systematic Review ◽  
Venous Thromboembolism ◽  
Systematic Reviews ◽  
Pelvic Surgery ◽  
Current Evidence ◽  
Cochrane Library ◽  
Vte Prophylaxis ◽  
Optimum Duration ◽  
Number Of Patients ◽  
Increased Risk

Abstract Background Venous thromboembolism (VTE) is a common postoperative complication associated with significant morbidity and mortality. The use of prophylactic heparin postoperatively reduces this risk, and the use of extended duration prophylaxis is becoming increasingly common. Malignancy and pelvic surgery both independently further increase the risk of postoperative VTE and patients undergoing major pelvic surgery for malignancy are at particularly high risk of VTE. However, the optimum duration of prophylaxis specifically in this population currently remains unclear. Methods We will conduct a systematic review of literature in accordance with the Cochrane Handbook for Systematic Reviews of Interventions (Higgins JPT, Green S. Cochrane Handbook for Systematic Reviews of Interventions version 5.1.0.,2011) to evaluate current evidence of the effectiveness and safety of inpatient versus extended VTE prophylaxis with heparin (all forms) following major pelvic surgery for malignancy. We will search PubMed, EMBASE, and the Cochrane Library. Regarding safety, Food and Drug Administration (FDA), and Therapeutic Goods Administration (TGA) websites will be searched, including all levels of evidence. Results will be the postoperative timeframe in which a VTE event can be considered to have been provoked by the surgery, and the number of patients needed to treat with both inpatient and extended prophylaxis to prevent a VTE event in this timeframe, comparing these to determine if there is a significant benefit from extended prophylaxis. Discussion This systematic review will aim to identify the postoperative period in which patients undergoing major pelvic surgery for malignancy are at further increased risk of VTE as a result of their surgery and the optimum duration of heparin VTE prophylaxis with heparin to reduce this risk. Determining this will allow evidence-based recommendations to be made for the optimum duration of heparin VTE prophylaxis post major pelvic surgery for malignancy, leading to improved standards of care that are consistent between different providers and institutions. Systematic review registration In accordance with guidelines, our systematic review was submitted to PROSPERO for consideration of registration on 16/12/17 and was registered on 12/1/18 with the registration number CRD42018068961, and it was last updated on December 1, 2018.

Genicular Artery Embolization for the Treatment of Knee Pain Secondary to Osteoarthritis

2020 ◽  
Vol 31 (7) ◽  
pp. 1096-1102 ◽  
Author(s):  
Sandeep Bagla ◽  
Rachel Piechowiak ◽  
Terry Hartman ◽  
Julie Orlando ◽  
Daniel Del Gaizo ◽  
...  
Keyword(s):  
Knee Pain ◽  
Artery Embolization ◽  
Genicular Artery

scholarly journals Single versus separate implant fixation for concomitant ipsilateral femoral neck and shaft fractures: A systematic review

2019 ◽  
Vol 11 (2) ◽  
Author(s):  
Kunal Mohan ◽  
Prasad Ellanti ◽  
Helen French ◽  
Niall Hogan ◽  
Tom McCarthy
Keyword(s):  
Systematic Review ◽  
Femoral Neck ◽  
Young Patients ◽  
Treatment Strategies ◽  
High Energy ◽  
Current Evidence ◽  
Implant Fixation ◽  
High Energy Trauma ◽  
Shaft Fractures ◽  
Significant Difference

Concomitant ipsilateral femoral neck and shaft fractures are uncommon, occurring in 1-9% of femoral shaft fractures. While this injury typically occurs in young patients following high-energy trauma, little consensus has been established regarding the optimal fixation approach. A multitude of treatment strategies exist, with limited evidence as to which is more favorable. The aim of this study was to appraise current evidence, comparing management with either one single or separate devices for both fractures. A systematic review was undertaken in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Studies published between 1992 and 2018 comparing the rate of postoperative nonunion, malunion, delayed union, avascular necrosis, infection or reoperation between at least one method of single device fixation and one method of separate device fixation were included. Six non-randomized cohort studies assessing 173 patients were suitable for inclusion, each comparing single device cephalomedullary nail fixation of both fractures with a combination of devices. All patients presented following high-energy trauma, at a median age of 32 years. While low complication rate and favorable outcomes were found across both groups, no significant difference could be inferred between either treatment strategy. This injury continues to occur in the traditionally described patient group, and results in acceptable postoperative outcomes. A paucity of randomized studies limits the ability to recommend a single or separate device treatment approach, and as such prospective, randomized trials with adequately powered sample sizes are required to definitively compare surgical management strategies in this rare but complex injury.

Systematic Review of the Efficacy and Safety of Alternative Azacitidine Regimens in Myelodysplastic Syndrome

Blood ◽  
2015 ◽  
Vol 126 (23) ◽  
pp. 2903-2903 ◽  
Author(s):  
Roman Shapiro ◽  
Alla Iansavichene ◽  
Alejandro Lazo-Langner
Keyword(s):  
Systematic Review ◽  
Myelodysplastic Syndrome ◽  
Dose Adjustment ◽  
Statistical Difference ◽  
Objective Response ◽  
Dosing Regimen ◽  
Randomized Controlled ◽  
Number Of Patients ◽  
Significant Difference ◽  
Dosing Regimens

Abstract Background 5-Azacitidine has been shown in randomized clinical trials to have a significant degree of efficacy with good tolerability in myelodysplastic syndrome (MDS) patients with intermediate/high risk according to the International Prognostic Scoring System (IPSS) score. The dosing regimen that was approved based on the AZA-001 randomized clinical trial was a 7-day 75mg/m2 regimen (7-0-0). However based on practical considerations, many centers use alternative regimens such as a 5-day 75mg/m2 (5-0-0) or 5-day followed by weekend break, followed by an additional 2-day (5-2-2) regimen at 75mg/m2. No randomized controlled trial has been done directly comparing all the different dosing regimens to ensure they attain the same efficacy as demonstrated for the 7-0-0 one. The objective of this study was to evaluate the efficacy and tolerability of the different dosing regimens of azacitidine in patients with MDS, chronic myelomonocytic leukemia (CMML) and acute myeloid leukemia with < 30% blasts (AML). Methods A systematic review of the literature was conducted using the MEDLINE and EMBASE databases. Eligible studies were randomized controlled trials, observational prospective and observational retrospective studies of various azacitidine regimens in MDS, CMML, or AML. Key extracted data included number of patients, azacitidine dosing, and clinical outcomes as per the International Working Group (IWG). The primary clinical outcome was Objective Response Rate (ORR) defined as the sum of complete response (CR) + partial response (PR) + hematological improvement (HI) by the IWG 2006 response criteria. The primary tolerability outcome was the proportion of patients requiring azacitidine dose adjustment as part of their treatment course. We conducted a meta-analysis of simple proportions using a random effects model with weights defined according to Laird and Mosteller. Comparisons between groups were not attempted due to the heterogeneity of study designs. Results Of the 2183 studies identified, 39 articles and 37 abstracts including 4868 patients were included in the analysis. There was a small number of studies directly comparing the different azacitidine regimens. Based on a total of two studies there was no statistical difference in terms of ORR between the 5-0-0 & 7-0-0 regimens. Based on a total of two studies, there was no statistical difference in terms of ORR between the 5-0-0 & 5-2-2 dosing regimens. The pooled proportion of ORR was 45% (variance 1.3%) for the 7-0-0 dosing regimen, 38% (variance 1.5%) for the 5-0-0 regimen, and 47% (variance 3.7%) for the 5-2-2 regimen. The 7-0-0 regimen resulted in 17% of patients requiring dose adjustment (variance 10%), the 5-0-0 regimen resulted in 34% of patients requiring dose adjustment (variance 4.3%), and the 5-2-2 regimen resulted in 25% of patients requiring dose adjustment (variance 15%). Conclusions There are few studies directly comparing the different dosing regimens of azacitidine in MDS, CMML, and AML in terms of their efficacy. Based on those studies that do, there is no statistically significant difference in terms of the ORR between the 5-0-0 & 7-0-0 treatments, and the 5-0-0 & 5-2-2 treatments. Pooled estimates for the ORR show similar results for the 3 dosing regimens evaluated, but indirect comparisons between groups were not conducted due to heterogeneity in the designs. Further studies directly comparing the azacitidine dosing regimens in MDS, CMML, and AML are required. Disclosures No relevant conflicts of interest to declare.

scholarly journals OralPanax notoginsengPreparation for Coronary Heart Disease: A Systematic Review of Randomized Controlled Trials

2013 ◽  
Vol 2013 ◽  
pp. 1-12 ◽  
Author(s):  
Qinghua Shang ◽  
Hao Xu ◽  
Zhaolan Liu ◽  
Keji Chen ◽  
Jianping Liu
Keyword(s):  
Systematic Review ◽  
Coronary Heart Disease ◽  
Heart Disease ◽  
Angina Pectoris ◽  
Cardiovascular Events ◽  
Randomized Clinical Trials ◽  
Panax Notoginseng ◽  
Small Sample ◽  
Current Evidence ◽  
Significant Difference

This systematic review aims to evaluate current evidence for the benefit and side effect of oralPanax notoginsengpreparation for coronary heart disease (CHD). We included 17 randomized clinical trials (17 papers and 1747 participants). Comparing with no intervention on the basis of conventional therapy, oralPanax notoginsengdid not show significant effect on reducing cardiovascular events, but it could alleviate angina pectoris (including improving the symptoms of angina pectoris [RR 1.20; 95% CI 1.12 to 1.28; 7 trials,n=791], improving electrocardiogram [RR 1.35; 95% CI 1.19 to 1.53; 8 trials,n=727], decreasing the recurrence of angina pectoris [RR 0.38; 95% CI 0.16 to 0.94; 1 trials,n=60], duration of angina pectoris [RR −1.88; 95% CI −2.08 to −1.69; 2 trials,n=292], and dosage of nitroglycerin [MD −1.13; 95% CI −1.70 to −0.56; 2 trials,n=212]); oralPanax notoginsenghad no significant difference compared with isosorbide dinitrate on immediate effect for angina pectoris [RR 0.96; 95% CI 0.81 to 1.15; 1 trial,n=80]. In conclusion, oralPanax notoginsengpreparation could relieve angina pectoris related symptoms. However, the small sample size and potential bias of most trials influence the convincingness of this conclusion. More rigorous trials with high quality are needed to give high level of evidence, especially for the potential benefit of cardiovascular events.

Positive Luminex and negative flow cytometry in kidney transplantation: a systematic review and meta-analysis

2018 ◽  
Vol 34 (11) ◽  
pp. 1950-1960 ◽  
Author(s):  
Jesmar Buttigieg ◽  
Hatem Ali ◽  
Ajay Sharma ◽  
Ahmed Halawa
Keyword(s):  
Systematic Review ◽  
Flow Cytometry ◽  
Kidney Transplantation ◽  
Graft Failure ◽  
Graft Function ◽  
Significant Risk ◽  
Pooled Analysis ◽  
Current Evidence ◽  
Low Level ◽  
Significant Difference

Abstract The presence of pre-formed donor-specific antibodies (DSAs) in kidney transplantation is associated with worse overall outcomes compared with DSA-negative transplantation. A positive complement-dependant cytotoxic crossmatch presents a high immunological risk, while a negative flow cytometry crossmatch is at the lower end of the risk spectrum. Yet, the presence of low-level DSA detected by Luminex alone, that is, positive Luminex and negative flow (PLNF) cytometry crossmatch lacks robust scientific exploration. In this systematic review and pooled analysis, we investigate the glomerular filtration rate, acute rejection (AR), graft survival and patient survival of PLNF transplants compared with DSA-negative transplants. Our analysis identified seven retrospective studies consisting of 429 PLNF transplants and 10 677 DSA-negative transplants. Pooled analysis identified no significant difference in the incidence of AR at 1 year [relative risk (RR) = 1.35, 95% confidence interval (CI) 0.90–2.02, Z = 1.46, P = 0.14, I2 = 0%], graft failure at 1 year (RR = 1.66, 95% CI 0.94–2.94, Z = 1.75, P = 0.08, I2 = 23%), graft failure at 5 years (RR = 1.29, 95% CI 0.90–1.87, Z = 1.38, P = 0.17, I2 = 0%), patient mortality at 1 year (RR = 0.89, 95% CI 0.31–2.56, Z = 0.22, P = 0.82, I2 = 0%) and patient mortality at 5 years (RR = 1.76, 95% CI 0.48–6.48, Z = 0.85, P = 0.39, I2 = 61%). Pooled analysis of graft function was not possible due to insufficient data. Current evidence suggests that low-level DSA detected by Luminex alone does not pose significant risk at least in the short–medium term. Considering the shortage of kidney transplants and the ever-increasing waiting time, the avoidance of PLNF transplants may be unwarranted especially in patients who have been enlisted for a long time.

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