Analysis of the Peak Systolic Velocity in the Transplant Renal Artery Anastomosis to Determine Normal Values in Patients Without Graft Dysfunction

2021 ◽  
pp. 875647932110298
Author(s):  
Cibele Luna ◽  
Farooq Hassan ◽  
Eduardo Scortegagna ◽  
Rosa Patricia Castillo
Keyword(s):  
Renal Artery ◽  
Iliac Artery ◽  
Peak Systolic Velocity ◽  
External Iliac Artery ◽  
Vascular Anastomosis ◽  
Renal Transplant Recipients ◽  
Transplant Recipients ◽  
Graft Dysfunction ◽  
Kidney Transplant Recipients ◽  
The Mean

Objective: The primary purpose is to define the mean renal artery anastomosis peak systolic velocity (RAA PSV) and the renal artery anastomosis to external iliac artery ratio (RAA-to-EIA) of renal transplant recipients without graft dysfunction. Moreover, to determine associations with type of vascular anastomosis and type of graft. Materials and Methods: This is a single-center retrospective analysis of kidney transplant recipients. Recorded variables included recipient age, type of vascular anastomosis, type of graft, RAA PSV, and external iliac artery PSV (EIA PSV). Such variables were evaluated on different postoperative follow-up periods. Results: There was a high degree of reliability between the RAA PSV and EIA PSV ( P < .001). The mean RAA PSV was 174 cm/s ± 72.9 cm/s with 95% confidence interval (CI) (162.2 cm/s-185.5 cm/s]. Conclusion: This study highlights the importance of determining the normal range of RAA PSV and showed that a high PSV does not necessarily indicate dysfunction.

Kidney graft function before pregnancy as a predictor of graft, maternal and fetal outcomes in pregnant renal transplant recipients

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Filipe S. Mira ◽  
Joana Oliveira ◽  
Filipa Sousa ◽  
Dora Antunes ◽  
Ana Carolina Figueiredo ◽  
...  
Keyword(s):  
Kidney Transplant ◽  
Graft Function ◽  
Adverse Outcomes ◽  
Hypertensive Disorder ◽  
Renal Transplant Recipients ◽  
Kidney Graft ◽  
Transplant Recipients ◽  
Graft Dysfunction ◽  
Kidney Transplant Recipients

Abstract Objectives Maternal and fetal complications can occur in pregnant kidney transplant recipients. Since these are high-risk pregnancies, they require a multidisciplinary follow-up to prematurely detect adverse events. Identifying factors that would affect fetal, maternal and graft outcomes is essential to further stratify the risk of pregnant kidney transplant recipients. Methods All pregnancies in kidney transplant recipients followed in a single center for 30 years were included. Data included previous transplant information and blood and urine tests performed before pregnancy. Impact of graft function on fetal, maternal and graft outcomes was evaluated. Results There were 41 pregnancies among 34 patients. Mean gestational age of 35 ± 3 weeks. Caesarean section was performed in 69.4% of patients. Five pregnancies were unsuccessful (12.2%). Four patients suffered an acute graft dysfunction (9.8%) and 12 (29.3%) had a serious maternal hypertensive disorder (preeclampsia, eclampsia or HELLP syndrome). Graft function before pregnancy showed significant correlation with adverse outcomes. Conclusions A proteinuria >669 mg/g, serum creatinine >1.75 mg/dL and glomerular filtration rate <36.2 mL/min/1.73 m2 before pregnancy were correlated to graft dysfunction during pregnancy. Similar values of proteinuria were also associated with a risk of maternal hypertensive disorders and pregnancy failure. Therefore, in patients with proteinuria and graft dysfunction, follow-up should be stricter to quickly detect complications.

scholarly journals Urological and surgical complications of renal transplant recipients as a single-center experience

2020 ◽  
pp. 101-110
Author(s):  
Safa Mezban ◽  
Adnan Athafa ◽  
Ismiel Abood
Keyword(s):  
Kidney Transplantation ◽  
Renal Transplant ◽  
Renal Artery ◽  
Iliac Artery ◽  
Surgical Complications ◽  
Surgical Complication ◽  
External Iliac Artery ◽  
Iliac Vein ◽  
Renal Transplant Recipients ◽  
Urological Complications

Background: Kidney transplantation is considered the most effective therapy for end-stage renal disease (ESRD). Postoperative complications continue to occur in nearly 12–20% of patients. These complications can be sub-divided into three categories: vascular, urologic, and nephrogenic. Objective: To determine the surgical and urological complications of renal transplant in Basra Training Center. Patients and Methods: A prospective descriptive study was done on 71 patients who underwent renal transplant surgery between October 2015 and August 2018. After taking their informed consent, preoperative antibiotics were given, and the procedure was done under general anesthesia. In all the transplantations, the renal vein of the donor was anastomosed to the external iliac vein of the recipient with an end-to-side. While the renal artery anastomosed to the internal iliac artery of the recipient with an endto-end for the first 50 cases, in the other 21 cases, renal artery anastomosed to the external iliac artery of the recipient with an end-to-side anastomosis. Ureters were anastomosed by the Lich–Gregoire procedure. Results: Overall, urological and surgical complications were encountered in 12 of the renal transplants recipients from the total number (71, 17%). This study included a total of 71 patients (59 male and 12 female, 83% and 17%, respectively). The complications that occurred during the follow-ups of the patients were as follows: one patient developed urinary leak (1.4%), five patients developed lymphocele (7%), four patients complained of acute pyelo nephritis (6%), one patients (1.4%) complained of wound infection, and one complained of renal stone (1.4%). Conclusions: In conclusion, urological complications such as lymphocele (7%) and acute graft pyelonephritis (AGPN) (6%) remain the most common type of surgical complications following kidney transplantation (in this study). Our urological and surgical complication rate was relatively low compared to others noted in the literature. Keywords: Kidney transplantation, ESRD, urinary leak, lymphocele

High Expression of FOXP3 mRNA in Blood and Urine as a Predictive Marker in Kidney Transplantation

2018 ◽  
Vol 28 (2) ◽  
pp. 134-141 ◽  
Author(s):  
Mehri Barabadi ◽  
Sanaz Keshavarz Shahbaz ◽  
Farshad Foroughi ◽  
Morteza Hosseinzadeh ◽  
Mohsen Nafar ◽  
...  
Keyword(s):  
Acute Rejection ◽  
Mrna Expression ◽  
Kidney Transplant ◽  
Renal Transplant Recipients ◽  
Transplant Recipients ◽  
Graft Dysfunction ◽  
Kidney Transplant Recipients ◽  
Foxp3 Mrna ◽  
Significant Difference ◽  
Noninvasive Biomarker

Background: Diagnosis of allograft dysfunction by noninvasive biomarker tests is preferable to invasive allograft biopsies and has been extensively considered in recent years. This study aims to evaluate blood and urinary forkhead box P3 (FOXP3) messenger RNA (mRNA) expression in renal transplant recipients in an attempt to determine whether differential diagnosis of graft dysfunction is feasible using mRNA profiles. Methods: We analyzed FOXP3 mRNA expression in paired urinary and peripheral blood mononuclear cell (PBMC) samples. A total of 91 kidney transplant recipients enrolled in this study that were classified into 3 groups: biopsy-proven acute rejection (AR; n = 27), chronic allograft nephropathy (n = 19), and well-functioning graft (n = 45). The FOXP3 mRNA expression was quantified by TaqMan probe real-time polymerase chain reaction. Results: Acute rejection patients had a higher expression level of transcription factor FOXP3 compared to the chronic nephropathy and control groups. Analysis of receiver operating characteristic curves showed that rejection could be diagnosed with 100% sensitivity and 96% specificity in urine, and 92% sensitivity and 86% specificity in PBMC samples using the optimal FOXP3 mRNA cutoff value. We subdivided the AR group into progressive and nonprogressive patients, which showed a significant difference in FOXP3 mRNA expression. This result confirmed the role of FOXP3 as a diagnostic marker in predicting transplantation outcomes. Conclusion: Our results suggested that elevated expression of FOXP3 in blood and urine samples from kidney transplant recipients could be a useful noninvasive biomarker to diagnose graft dysfunction.

Evaluation of Filgrastim Therapy in Kidney Transplant Recipients

2017 ◽  
Vol 27 (4) ◽  
pp. 360-364 ◽  
Author(s):  
Teresa Poon ◽  
Christina M. Guerra
Keyword(s):  
Kidney Transplant ◽  
Renal Transplant Recipients ◽  
Transplant Recipients ◽  
Kidney Transplant Recipients ◽  
Duration Of Treatment ◽  
Adult Kidney ◽  
Serious Infections ◽  
The Mean ◽  
Short Courses

Context: Neutropenia is associated with a high risk of serious infections in kidney transplant recipients. There are no sufficient studies of using granulocyte colony-stimulating factors, such as filgrastim, in renal transplant recipients to establish a clear, specified role of this off-label indication. Using filgrastim in these patients may increase the risk of rejection by overstimulating the immune system. Objective: To evaluate the use of filgrastim in adult kidney transplant recipients presenting with neutropenia. Patients and Design: Data were obtained from a medication utilization report of filgrastim in kidney transplant recipients at our center from September 2012 to August 2015. Main Outcome Measure(s) and Results: There were 28 cases of neutropenia that were treated with a range of 1 to 5 doses of filgrastim 300 or 480 μg, with a mean of 1.79 doses. The mean total dose of filgrastim administered per episode of neutropenia was 632 μg (8.6 μg/kg). Overall, 87.5% of the cases achieved a white blood cell count of at least 3 × 109 cells/L within 7 days of hospital discharge. There were no cases of infection or acute rejection following treatment. Conclusions: The use of filgrastim in kidney transplant recipients demonstrated success in reversing neutropenia. Short courses of therapy were required with minimal adverse events. Patients who required readmission were successfully re-treated. Additional studies are required to determine the most effective dose and duration of treatment.

scholarly journals BK Virus Associated Nephropathy, a Cause of Early Renal Allograft Dysfunction: A Single Centre Study

2017 ◽  
Vol 13 (2) ◽  
pp. 140-145
Author(s):  
S. Shrestha ◽  
P.G. Kerr ◽  
J. Kanellis ◽  
K.R. Polkinghorne ◽  
F. Brown ◽  
...  
Keyword(s):  
Renal Transplant ◽  
De Novo ◽  
Bk Virus ◽  
Renal Transplant Recipients ◽  
Transplant Recipients ◽  
Graft Dysfunction ◽  
Early Graft ◽  
The Mean ◽  
The Difference ◽  
Early Graft Dysfunction

Background BK virus associated nephropathy (BKVN) is an important cause of early graft dysfunction in renal transplant recipients. The present study was carried out to determine the burden of BKVN in a single renal transplant centre in Australia.Method A retrospective analysis of de novo renal transplant recipients from 2010 to 2013 was performed to identify biopsy proven BKVN. Estimated glomerular filtration rate (eGFR) was compared at baseline, at BKVN diagnosis and 3 and 12 months post-diagnosis.Result Of the 317 de novo renal transplants recipients in the study period, 20 (6.3%) developed BKVN. The mean age was 54.8 ± 13.1 years and 13 (65%) were male. The mean time from transplant to BKVN was 8.7 ± 6.7 months with 17 (85%) diagnosed within 12 months. Four recipients each were diagnosed BKVN on 3 and 12 month surveillance biopsy. Six (30%) had normal eGFR at diagnosis. Mean eGFR at diagnosis was 38.8 ± 19.2 ml/min/1.73 m2, which was significantly lower (p < 0.01) than that at baseline (50.3 ± 16.4 ml/min/1.73 m2). eGFR improved numerically at 3 and 12 months post-diagnosis, however the difference was not significant. One patient had graft failure, 19 months after diagnosis.Conclusion BKVN generally occurs in first post-transplant year and is an important cause of early graft dysfunction. Surveillance biopsy helps in detecting subclinical BKVN.

scholarly journals Transplant renal artery stenosis without hypertension: A case report

2019 ◽  
Vol 9 (1) ◽  
pp. e11-e11
Author(s):  
Fereshteh Saddadi ◽  
Seyyed Mehdi Hoseini ◽  
Faezeh Rasolian ◽  
Mohammad Hassan Fallahkohan
Keyword(s):  
Case Report ◽  
Renal Transplantation ◽  
Renal Artery ◽  
Renal Artery Stenosis ◽  
Graft Loss ◽  
Artery Stenosis ◽  
Diagnostic Tools ◽  
Transplant Recipients ◽  
Graft Dysfunction ◽  
Kidney Transplant Recipients

In kidney transplant recipients, the renal artery stenosis is cause of graft dysfunction and graft loss. Here we describe a case that leads to graft loss. The nephrologist should know about its etiologies, symptoms and diagnostic tools and also its treatment after renal transplantation.

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