Analysis of donor selection for living related kidney transplantation and their postoperative outcome

Lack of cadaveric organs for transplantation resulted in increased number of living related kidney donors examinations and consequent transplantations in our Department. Donor procedure, selection, drop-outs and final results for living related donors (LRD) were retrospectively analyzed in this paper. Between 1987 and 1994 202 potential LRD were examined. Most of them were females (59%) and about 30% were older than 60 years. The family relation between LRD and recipients were: parents (95%), siblings (3%), grandmother grandfather (1.5%) and uncle (0.5%). Potential LRD were informed on risks advantages and procedure of living donor transplantation. After primary information 26% of potential LRD gave up further examinations. Following immunological and clinical evaluations 48% of LRD actually donated a kidney. The other 26% were excluded during the selection procedure. High immunological risks including ABO incompatibility, HLA mismatches and positive cross match test were the reasons for drop outs of 35 potential LRD (17%). Five more donors were excluded for medical reasons: one because of low creatinine clearance and four because of neoplasms, discovered during examination (kidney, laryngeal, lung). Fourteen transplantation were not realized due to different recipient reasons: 5 of them had clinical contraindications, two died and in 7 cadaveric kidney transplantations were performed. Mild hypertension, coronary disease and diabetes mellitus type 2 were presented in 5 LRD accepted for transplantation. Five more had to be operated before donation (abdominal or urological operation). Early complications after donor nephrectomy were acute renal failure, stress ulcus, pleuropneumonia in three and thromboflebitis in two donors. In conclusion, although kidney transplantation from LRD is highly successful careful examination during selection procedure is indispensable.

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ANTI-AB TITER CHANGES IN PATIENTS WITH ABO INCOMPATIBILITY AFTER LIVING RELATED KIDNEY TRANSPLANTATIONS

Transplantation Journal ◽

10.1097/00007890-200008270-00024 ◽

2000 ◽

Vol 70 (4) ◽

pp. 681-685 ◽

Cited By ~ 71

Author(s):

Hideki Ishida ◽

Ichiro Koyama ◽

Tokihiko Sawada ◽

Ken Utsumi ◽

Toru Murakami ◽

...

Keyword(s):

Abo Incompatibility ◽

Kidney Transplantations ◽

Living Related

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Kidney Transplantation Program in Montenegro

BANTAO Journal ◽

10.1515/bj-2015-0015 ◽

2015 ◽

Vol 13 (2) ◽

pp. 68-72

Author(s):

Marina Ratkovic ◽

Nikolina Basic Jukic ◽

Danilo Radunovic ◽

Vladimir Prelevic ◽

Branka Gledovic

Keyword(s):

Kidney Transplantation ◽

Good Condition ◽

Organ Donor ◽

Deceased Donor ◽

Terminal Organ ◽

Clinical Center ◽

Transplantation Program ◽

Organ Markets ◽

Kidney Transplantations ◽

Living Related

AbstractIntroduction.There was no transplantation program in Montenegro until 2012. On the other hand, there were 93 patients with transplanted kidney. These transplantations were performed abroad; 15% in areas of black organ markets (India, Pakistan, Russian Federation). Beside the ethical problems, these transplantations carried a high risk of complications.Methods.Our health system had to ensure solution for patients with terminal organ failure. Preparation of all neccessary conditions for the beginning of transplantation program in Montenegro started in 2006 with different activities including public, legal, medical, educational and international cooperation aspects.Results.The first kidney transplantation from living donor in Montenegro was preformed on September 25th, 2012. In the period from 2012 until now 23 kidney transplantations from living related donor were performed and one kidney transplantation from deceased donor in the Clinical Center of Montenegro. In the a two year-follow-up period, all patients to whom kidney transplantation was performed are in a good condition and without serious complications in posttransplant period.Conclusion.Development of the transplantation program allowed controlled transplantation and safety of patients. Our next steps are development of deceased organ donor transplantation and achievement of higher rate of deceased donor organ transplantation and individualization of immunosuppressive therapy.

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Living-Related Kidney Transplantation in a Patient with Juvenile Nephronophthisis

Nephron ◽

10.1159/000508501 ◽

2020 ◽

Vol 144 (11) ◽

pp. 583-588

Author(s):

Matej Vnučák ◽

Karol Graňák ◽

Petra Skálová ◽

Ľudovít Laca ◽

Marián Mokáň ◽

...

Keyword(s):

Kidney Transplantation ◽

Autosomal Recessive ◽

Kidney Diseases ◽

Dominant Mode ◽

Kidney Donation ◽

Living Kidney Donation ◽

Potential Donor ◽

Living Donor Transplantation ◽

Recessive Homozygote ◽

Living Related

Nephronophthisis (NPHP) is an autosomal recessive disease manifesting as tubulointerstitial nephritis uniformly progressing to ESRD in approximately 5–10% patients in childhood. Living donor transplantation is the most beneficial mean of renal replacement therapy compared to other methods. However, living kidney donation is contraindicated in potential donor with diseases of autosomal dominant mode of inheritance potentially leading to kidney failure in future. On the other hand, autosomal recessive genetic kidney diseases, such as NPHP, are not usually contraindication to living kidney donation. Herein, we are reporting related living kidney transplantation with a family history of NPHP form 46-year-old mother (heterozygote) to 17-year-old daughter with (autosomal recessive homozygote) with focus on donor follow-up after nephrectomy.

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Ureteral fistulae after kidney transplantation: Experience with 224 cases

Acta chirurgica iugoslavica ◽

10.2298/aci1101089b ◽

2011 ◽

Vol 58 (1) ◽

pp. 89-94 ◽

Cited By ~ 1

Author(s):

Dragan Basic ◽

Jovan Hadzi-Djokic ◽

Drago Milutinovic ◽

Zoran Dzamic ◽

Cedomir Topuzovic ◽

...

Keyword(s):

Kidney Transplantation ◽

Open Repair ◽

Fistula Repair ◽

Lethal Outcome ◽

Urological Complications ◽

Living Donor Transplantation ◽

Donor Type ◽

Ureteral Fistula ◽

Kidney Transplantations ◽

Considerable Morbidity

Ureteral fistulae after kidney transplantation represent major early urological complications with reported incidence from 1.2% to 12% in large series. The aim of the study is to establish the incidence, types and ureteral fistula related morbidity and lethality rates, by donor type. From 1995. to 2001, a total of 224 kidney transplantations (171 from living and 53 from cadaveric donor) have been performed at the Institute of Urology and Nephrology in Belgrade. Mean patients age was 36,67 years (11- 64; SD=10,69). Ureteral fistulae appeared only after living donor transplantation in a total of five patients (2.2%) (p>0.05). In all patients open fistula repair was performed. Two patients had recidive ureteral fistula after primary and after secondary open repair. Following the third open repair one patient had lethal outcome. Ureteral fistulae after kidney transplantation still remain challenging urological problem with considerable morbidity and lethality rates.

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The Effects of Human Atrial Natriuretic Peptide on the Recipients of Living-related Kidney Transplantation.

THE JOURNAL OF JAPAN SOCIETY FOR CLINICAL ANESTHESIA ◽

10.2199/jjsca.18.698 ◽

1998 ◽

Vol 18 (9) ◽

pp. 698-701

Author(s):

Junji SASAKI ◽

Rie YAMAMOTO ◽

Takashi TSUGUMA ◽

Hirosato KIKUCHI

Keyword(s):

Kidney Transplantation ◽

Atrial Natriuretic Peptide ◽

Natriuretic Peptide ◽

Human Atrial Natriuretic Peptide ◽

Living Related ◽

Atrial Natriuretic

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Novel diagnostic and therapeutic techniques reveal changed metabolic profiles in recurrent focal segmental glomerulosclerosis

Scientific Reports ◽

10.1038/s41598-021-83883-w ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Janina Müller-Deile ◽

George Sarau ◽

Ahmed M. Kotb ◽

Christian Jaremenko ◽

Ulrike E. Rolle-Kampczyk ◽

...

Keyword(s):

Kidney Transplantation ◽

Raman Spectra ◽

Focal Segmental Glomerulosclerosis ◽

Disease Recurrence ◽

Early Recurrence ◽

Metabolome Analysis ◽

Novel Technologies ◽

Filtration Barrier ◽

Segmental Glomerulosclerosis ◽

Living Related

AbstractIdiopathic forms of Focal Segmental Glomerulosclerosis (FSGS) are caused by circulating permeability factors, which can lead to early recurrence of FSGS and kidney failure after kidney transplantation. In the past three decades, many research endeavors were undertaken to identify these unknown factors. Even though some potential candidates have been recently discussed in the literature, “the” actual factor remains elusive. Therefore, there is an increased demand in FSGS research for the use of novel technologies that allow us to study FSGS from a yet unexplored angle. Here, we report the successful treatment of recurrent FSGS in a patient after living-related kidney transplantation by removal of circulating factors with CytoSorb apheresis. Interestingly, the classical published circulating factors were all in normal range in this patient but early disease recurrence in the transplant kidney and immediate response to CytoSorb apheresis were still suggestive for pathogenic circulating factors. To proof the functional effects of the patient’s serum on podocytes and the glomerular filtration barrier we used a podocyte cell culture model and a proteinuria model in zebrafish to detect pathogenic effects on the podocytes actin cytoskeleton inducing a functional phenotype and podocyte effacement. We then performed Raman spectroscopy in the < 50 kDa serum fraction, on cultured podocytes treated with the FSGS serum and in kidney biopsies of the same patient at the time of transplantation and at the time of disease recurrence. The analysis revealed changes in podocyte metabolome induced by the FSGS serum as well as in focal glomerular and parietal epithelial cell regions in the FSGS biopsy. Several altered Raman spectra were identified in the fractionated serum and metabolome analysis by mass spectrometry detected lipid profiles in the FSGS serum, which were supported by disturbances in the Raman spectra. Our novel innovative analysis reveals changed lipid metabolome profiles associated with idiopathic FSGS that might reflect a new subtype of the disease.

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Preemptive Kidney Transplantation of Living Related or Unrelated Donor–Recipient Combinations

Transplantation Proceedings ◽

10.1016/j.transproceed.2008.06.023 ◽

2008 ◽

Vol 40 (7) ◽

pp. 2294-2296 ◽

Cited By ~ 3

Author(s):

N. Ishikawa ◽

T. Yagisawa ◽

Y. Sakuma ◽

T. Fujiwara ◽

A. Nukui ◽

...

Keyword(s):

Kidney Transplantation ◽

Unrelated Donor ◽

Living Related ◽

Preemptive Kidney Transplantation

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Laparoscopic-Assisted Recipient Nephrectomy and Recipient Kidney Procurement during Orthotopic Living-Related Kidney Transplantation

Case Reports in Transplantation ◽

10.1155/2011/153493 ◽

2011 ◽

Vol 2011 ◽

pp. 1-4 ◽

Cited By ~ 1

Author(s):

Dimitri Mikhalski ◽

Karl Martin Wissing ◽

Renaud Bollens ◽

Daniel Abramowicz ◽

Vincent Donckier ◽

...

Keyword(s):

Kidney Transplantation ◽

Antiphospholipid Antibodies ◽

Graft Function ◽

Renal Vessels ◽

Short Period ◽

History Of ◽

Stage Renal Disease ◽

End Stage ◽

Living Related ◽

Laparoscopic Assisted

Advanced atherosclerosis or thrombosis of iliac vessels can constitute an absolute contraindication for heterotopic kidney transplantation. We report the case of a 42-year-old women with end-stage renal disease due to lupus nephritis and a history of bilateral thrombosis of iliac arteries caused by antiphospholipid antibodies. Occlusion had been treated by the bilateral placement of wall stents which precluded vascular anastomosis. The patient was transplanted with a right kidney procured by laparoscopic nephrectomy from her HLA semi-identical sister. The recipient had left nephrectomy after laparoscopical transperitoneal dissection. The donor kidney was orthotopically transplanted with end-to-end anastomosis of graft vessels to native renal vessels and of the graft and native ureter. Although, the patient received full anticoagulation because of a cardiac valve and antiphospholipid antibodies, she had no postoperative complication in spite of a short period of delayed graft function. Serum creatinine levels three months after transplantation were at 1.0 mg/dl. Our case documents that orthotopical transplantation of laparoscopically procured living donor kidneys at the site of recipient nephrectomy is a feasible procedure in patients with surgical contraindication of standard heterotopic kidney transplantation.

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