scholarly journals Verapamil improves the outcome after cadaver renal transplantation.

1991 ◽  
Vol 2 (5) ◽  
pp. 983-990
Author(s):  
I Dawidson ◽  
P Rooth ◽  
C Lu ◽  
A Sagalowsky ◽  
K Diller ◽  
...  
Keyword(s):  
Blood Flow ◽  
Renal Transplantation ◽  
Renal Transplant ◽  
Oral Administration ◽  
Renal Artery ◽  
Graft Survival ◽  
Antilymphocyte Globulin ◽  
Acute Renal Dysfunction ◽  
Transplant Patients ◽  
Blood Flow Velocities

Because of their favorable effects on renal hemodynamics, calcium antagonists may have a major role in the prevention and management of certain types of acute renal dysfunction. In fact, verapamil (VP) was shown to prevent cyclosporin A (CsA)-induced decreases in RBF in mice and in cadaver renal transplant (CRT) recipients. The study presented here of 59 cadaver renal transplant patients evaluates the outcome from perioperative treatment with VP (N = 30) administered intraoperatively into the renal artery (10 mg) followed by oral administration of 120 mg every 8 to 12 h for 14 days versus no drug (N = 29). Early immunosuppression included azathioprine, corticosteroids, and antilymphocyte globulin with subsequent overlapping with CsA on days 5 and 6. Actuarial graft survival at 1 yr was different when the two groups were compared (P less than 0.05). Estimated graft survival at 1 yr for VP patients was 93.3 compared with 72.4% in control patients. The improved graft survival was most striking in repeat transplants with 90% graft survival at 1 yr for VP recipients versus 37.5% for controls. Compared with controls, VP recipients had significantly improved renal parenchymal diastolic blood flow velocities on the first day after surgery (7.8 versus 5.8 cm/s). By day 7, GFR were greater with VP (44 +/- 29 mL/min) versus controls (28 +/- 22 mL/min). Of VP patients, 67% (18 of 24) had GFR greater than 30 mL/min versus 33% (9 of 26) for control patients. Similarly, on the seventh day, 77% (21 of 30) of VP patients had serum creatinines less than 2.0 mg% versus 34% (10 of 29) for controls.(ABSTRACT TRUNCATED AT 250 WORDS)

scholarly journals P1619OUTCOME OF HIGH DONOR-RECIPIENT AGE GAP IN LIVE-DONOR RENAL TRANSPLANTS IN TACROLIMUS ERA

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Hatem Kaies Ibrahim Elsayed Ali ◽  
Ahmed Daoud ◽  
Karim Soliman ◽  
Mahmoud Mohamed ◽  
Asam Murtaza
Keyword(s):  
Renal Transplant ◽  
Acute Rejection ◽  
Graft Survival ◽  
Age Difference ◽  
Live Donor ◽  
Renal Transplants ◽  
Transplant Patients ◽  
Age Gap ◽  
Group A ◽  
Recipient Age

Abstract Background and Aims High donor-recipient age gap among deceased-donor renal transplant patients leads to worse outcomes. However, the impact of this gap among live-donor renal transplants is unclear. The aim of this study is to assess the effect of this age gap on graft survival and acute rejection rates among renal transplants in tacrolimus era. Method 14390 live-donor renal transplant patients who received a single organ transplant, had no previous renal transplants, discharged on tacrolimus-based immunotherapy and were registered in the Organ Procurement Transplantation Network from January 2000 till June 2017 were included in the study. Donor–recipient age difference was divided into 5 groups; group A (difference <−10,n=4375), group B (difference from -10 to 10,n=7229), group C (difference between 10-20, n=861), group D ( difference between 20–29, n=1406) and group E (difference ≥30 years, n=519). Poisson regression analysis was used to assess effect of age gap on acute rejection rates. Kaplan-Meier survival curves and Cox hazard regression analysis were used to assess this effect on graft survival. Results Regarding graft survival, groups with age difference ≥30 years and between 20-29 years showed a significantly higher risk of graft loss when compared to group with age difference <−10 (HR equals 4.6 and 3.8 respectively). Groups with age difference between 10 to 20 years and between -10 to 10 years showed no significant difference in graft survival when compared to same group (HR equals 1.03 and 0.95 respectively). Groups B,C,D,E were not associated with increased risk of acute rejection episodes when compared to group A (IRR=1.001, 1.001, 1.022, 1.027 respectively). Conclusion Donor-recipient age difference up to 20 years has similar renal transplant outcomes to those receiving kidneys from younger donors and therefore, should not be precluded from paired kidney donation programs. The donor-recipient age difference above 20 years is associated with worse outcomes in terms of graft survival.

Basic science and renal transplant

2019 ◽  
pp. 827-846
Author(s):  
John Reynard ◽  
Simon F Brewster ◽  
Suzanne Biers ◽  
Naomi Laura Neal
Keyword(s):  
Blood Flow ◽  
Renal Transplantation ◽  
Renal Replacement Therapy ◽  
Renal Transplant ◽  
Basic Science ◽  
Renal Physiology ◽  
Physiological Functions ◽  
Organ Rejection ◽  
Sodium And Potassium ◽  
Donor Transplant

This chapter covers the basic physiological functions of the kidney, bladder, and urethra. Renal anatomy is detailed, including the anatomical relations of the kidney. Renal physiology is covered in detail, including the regulation of renal blood flow and regulation of water, acid–base, sodium, and potassium balance. It includes the principles of renal replacement therapy and the principles of renal transplantation, including assessment of both the recipient and the donor. Transplant surgery is outlined, including commonly used drugs and complications and their management and common complications of renal transplant surgery. The different types of organ rejection are discussed, including their treatments.

P1763TUBERCULOSIS IN RENAL TRANSPLANT RECEPIENTS - DO RITUXIMAB AND OTHER IMMUNOSUPRESSION HAVE A ROLE?

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Anupma Kaul ◽  
Dharmendra Bhaduria ◽  
Narayan Prasad ◽  
Amit Gupta
Keyword(s):  
Renal Transplantation ◽  
Renal Transplant ◽  
Immunosuppressive Agents ◽  
Induction Agent ◽  
Renal Transplant Recipients ◽  
Transplant Recipients ◽  
Transplant Patients ◽  
Significant Difference ◽  
High Prevalence ◽  
Mean Time

Abstract Background and Aims Rituximab is an anti CD 20 agent used widely in renal transplant recipients. Its use is associated with various infections;however, its association with Tuberculosis (TB) is not well established and has not been studied in post renal transplantation patients. Method This is a single centre, retrospective analysis of 56 renal transplant recipients who received rituximab for various reasons and 287 post renal transplant patients who did not receive rituximab during the study period from January 2013 to June 2017. The association between use of rituximab and incidence of TB was studied. Other factors associated with tuberculosis were also investigated. Results Baseline characteristics were similar in both the groups. Mean time for occurrence of TB was 18.4 + 10.6 months after renal transplantation. Rituximab use was not significantly associated with tuberculosis or any other infection. Higher number of rejection episodes (60% vs 32.72%, p=0.029) was the only factor associated with greater incidence of TB. However, no specific type of rejection was associated with tuberculosis. Use of plasmapheresis in post transplant period for treatment of humoral rejections was associated with significantly higher incidence of TB (33.33% vs 13.41%, p=0.031), however when pre- transplant plasmapheresis was also considered, there was no significant difference. The choice of induction agent was not associated with higher incidence of TB. Conclusion Use of rituximab is not associated with higher incidence of TB when compared to other immunosuppressive agents. Routine screening and prophylaxis may not be advisable especially in a country like India with high prevalence of TB; as it will further delay transplantation and may adversely affect the outcome of the patients.

Mycophenolate mofetil, an inhibitor of inosine monophosphate dehydrogenase, causes a paradoxical elevation of GTP in erythrocytes of renal transplant patients

2004 ◽  
Vol 107 (1) ◽  
pp. 63-68 ◽  
Author(s):  
David GOLDSMITH ◽  
Elizabeth A. CARREY ◽  
Stephen EDBURY ◽  
Ryszard T. SMOLENSKI ◽  
Piotr. JAGODZINSKI ◽  
...  
Keyword(s):  
Mycophenolate Mofetil ◽  
Renal Transplantation ◽  
Renal Transplant ◽  
Plasma Metabolites ◽  
Renal Transplant Recipients ◽  
Inosine Monophosphate Dehydrogenase ◽  
Inosine Monophosphate ◽  
Transplant Patients ◽  
Renal Transplant Patients ◽  
Monophosphate Dehydrogenase

The immunosuppressant MMF (mycophenolate mofetil) has increasingly replaced AZA (azathioprine) in renal transplantation. MMF is a prodrug of MPA (mycophenolic acid), which inhibits lymphocyte IMPDH (inosine monophosphate dehydrogenase), thereby drastically decreasing GTP concentrations essential to lymphocyte proliferation in vitro and in vivo. Erythrocyte GTP concentrations are commonly elevated in severe renal disease, but normalize following successful engraftment. Consequently, elevated GTP in renal transplant recipients might signal impending loss of immunosuppression and graft failure. In the present study, we compared erythrocyte nucleotides and plasma metabolites in two groups of 25 patients after renal transplantation, both receiving prednisolone and cyclosporin A, but one group receiving MMF and the other AZA. No patients had recent allograft biopsy evidence of rejection. Erythrocyte GTP concentrations at MMF commencement were 50.4±23.4 μmol/l. An increase occurred during the first 3 months after transplant when MMF was used de novo, stabilizing at 146.7±62.9 μmol/l after 4 months. This was significantly higher (P=2.5×10−6) than erythrocyte GTP (40.4±15.9 μmol/l) in the AZA group, which was essentially unchanged from values immediately after successful transplantation. The effect of MMF on erythrocyte GTP levels was reversible, since GTP levels fell when MMF therapy was terminated. The results demonstrate paradoxically high GTP concentrations in erythrocytes of renal transplant patients receiving MMF. MPA may stabilize reticulocyte IMPDH, allowing the protein to persist during erythropoiesis. This behaviour is in marked contrast with the decrease in GTP levels seen in white blood cells of patients on chronic MMF therapy.

Transplantations: Implications of the Renal Transplantation Process for Rehabilitation Counselors

1993 ◽  
Vol 24 (1) ◽  
pp. 34-37
Author(s):  
Rick Houser ◽  
Varda Konstam
Keyword(s):  
Renal Transplantation ◽  
Chronic Illness ◽  
Renal Transplant ◽  
Functional Limitations ◽  
Rehabilitation Counselors ◽  
Rehabilitation Counselor ◽  
Transplant Patients ◽  
The Family ◽  
Renal Transplant Patients

Renal transplantation is one of the most common forms of transplantation performed today. The rehabilitation counselor may provide an important role in the rehabilitation of persons that have gone through renal transplantation. For example, the rehabilitation counselor can provide information on the effects of experiencing a chronic illness and provide information on the changes in the family as a result of the chronic illness. However, if the rehabilitation counselor is to be helpful to renal transplant patients they must be knowledgeable about the renal transplantation process. In this article we address the renal transplantation process including: the medical aspects, functional limitations, psychological implications and finally vocational implications as they relate to the rehabilitation counselor.

Different patterns of BK and JC polyomavirus reactivation following renal transplantation

2010 ◽  
Vol 63 (8) ◽  
pp. 714-718 ◽  
Author(s):  
Baljit K Saundh ◽  
Stephen Tibble ◽  
Richard Baker ◽  
Kestutis Sasnauskas ◽  
Mark Harris ◽  
...  
Keyword(s):  
Renal Transplantation ◽  
Renal Transplant ◽  
Jc Virus ◽  
Teaching Hospitals ◽  
Renal Transplant Recipients ◽  
Plasma Samples ◽  
Jc Polyomavirus ◽  
Post Transplantation ◽  
Transplant Patients ◽  
Multiplex Pcr Assay

AimReactivation of latent BK polyomavirus (BKV) infection is relatively common following renal transplantation and BKV-associated nephropathy has emerged as a significant complication. JC polyomavirus (JCV) reactivation is less well studied. The aim of the study was to determine reactivation patterns for these polyomaviruses in renal transplant recipients using an in-house quantitative real-time multiplex PCR assay and IgG serological assays using recombinant BK and JC virus-like particles.MethodsRetrospective analysis of urine and plasma samples collected from 30 renal transplant patients from February 2004 to May 2005 at Leeds Teaching Hospitals NHS Trust. Samples were collected at 5 days and thereafter at 1, 3, 6 and 12 months post-transplantation.ResultsEight patients (26.7%) were positive for BK viruria; three of these patients submitted plasma samples and two had BK viraemia. Five patients (16.7%) were positive for JC viruria. A corresponding rise in BKV and JCV antibody titres was seen in association with high levels of viruria.ConclusionsDifferent patterns of reactivation were observed: BK viruria was detected after 3–6 months, and JC viruria was observed as early as 5 days post-transplantation. One patient had biopsy-proven BKV nephropathy. No dual infections were seen. In order to ensure better graft survival, early diagnosis of these polyomaviruses is desirable.

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