scholarly journals Patient and kidney graft survival rates after first and second kidney transplantation

2021 ◽  
Vol 13 (2) ◽  
pp. 130-140
Author(s):  
M. Sh. Khubutiya ◽  
A. V. Pinchuk ◽  
N. V. Shmarina ◽  
I. V. Dmitriev ◽  
V. E. Vinogradov ◽  
...  
Keyword(s):  
Kidney Transplantation ◽  
Graft Survival ◽  
Survival Rates ◽  
Kidney Graft ◽  
Significant Difference ◽  
Donor Type ◽  
Expanded Criteria ◽  
Expanded Criteria Donors ◽  
Kidney Transplantations ◽  
One Year

Introduction. Expanding donation criteria is one way of solving the problem of the increasing need of transplantation. The article is dedicated to comparison of the outcomes of first and second repeated kidney transplantation using grafts from standard criteria and expanded criteria donors.Aim. To evaluate 1-year and 5-year recipient and kidney graft survival rates after first and second kidney transplantation according to the donor type – standard criteria or expanded criteria donors.Material and methods. From 2007 till 2019 we performed 1459 kidney transplantations. The comparison study of outcomes of first (n=196) and second (n=143) kidney transplantations from standard criteria (n=245) and expanded criteria (n=94) donors was made.Results. There were no significant differences in a 1-year patient survival according to the donor type (98% and 95%, p=0.13). A 5-year recipient survival was significantly poorer after kidney transplantation from expanded criteria donors (97.6% and 88%, p=0.01). There were no significant differences in 1-year and 5-year graft survival rates according to the order of transplantation (p=0.21 and p=0.36). We found no significant difference in 1-year recipient survival after kidney transplantation from expanded criteria donors according to the order of transplantation (p=0.50). A 5-year recipient survival was significantly difference poorer after second kidney transplantation from expanded criteria donors (p=0.04). One-year and 5-year graft survival rates were significantly lower after kidney transplantation from expanded criteria donors (94%, 88% vs 86%, 65%, p=0.0025 and p=0.0011, respectively). One-year and 5-year survival rates were higher after first kidney transplantation from standard criteria donors in comparison with second kidney transplantation (p=0.052 and p=0.02, statistically significant in both cases). Analyzing outcomes of kidney transplantation from expanded criteria donors we found 1-year and 5-year graft survivals to be higher after first kidney transplantation comparing with second kidney transplantation (p=0.030 and p=0.018, statistically significant in both cases).Conclusion. In case of second organ transplantation, it is reasonable to use organs from standard criteria donors.

scholarly journals Comparison of Outcomes of Kidney Transplantation From Extremely Low Body Weight ≤5kg Versus Larger Body Weight Pediatric Donors

2021 ◽  
Vol 12 ◽  
Author(s):  
Jiawei Peng ◽  
Helong Dai ◽  
Hedong Zhang ◽  
Shaojie Yu ◽  
Xubiao Xie ◽  
...  
Keyword(s):  
Body Weight ◽  
Kidney Transplantation ◽  
Graft Survival ◽  
Survival Rates ◽  
En Bloc ◽  
Urinary Leakage ◽  
Surgical Methods ◽  
Significant Difference ◽  
Pediatric Recipients ◽  
Pediatric Donors

BackgroundKidney transplantation from donors who weigh ≤5 kg is performed at only a few transplant centers owing to the high complication and low graft survival rates associated with this approach.MethodsWe retrospectively compared the results of kidney transplantation at our center between January 2015 and December 2019 based on the following pediatric donor criteria: donor body weight ≤5 kg (n=32), 5 kg< donor weight ≤20 kg (n=143), and donor weight >20 kg (n=110). We also perform subgroup analysis of kidney transplantation outcomes from ≤5 kg donors, using conventional (dual separate and classic en-bloc KTx)/novel (en-bloc KTx with outflow tract) surgical methods and allocating to adult/pediatric recipients.ResultsThe death-censored graft survival rates from extremely low body weight ≤5kg at 1 month, and 1, 3, and 5 years were 90.6%, 80.9%, 77.5%, and 73.9%, respectively, which were significantly lower than that from larger body weight pediatric donors. However, the 3-, and 5-year post-transplantation eGFRs were not significantly different between the pediatric and adult recipient group. The thrombosis (18.8%) and urinary leakage (18.8%) rates were significantly higher in the donor weight ≤5 kg group. Compared with 5 kg< donor weight ≤20 kg group, donor weight ≤5kg group was at elevated risk of graft loss due to thrombosis (OR: 13.4) and acute rejection (OR: 6.7). No significant difference on the outcomes of extremely low body weight donor kidney transplantation was observed between adults and pediatric recipients. Urinary leakage rate is significantly lower in the novel operation (8.7%) than in the conventional operation group (44.4%).ConclusionsAlthough the outcomes of donor body weight ≤5kg kidney transplantation is inferior to that from donors with large body weight, it can be improved through technical improvement. Donors with body weight ≤5 kg can be considered as an useful source to expand the donor pool.

scholarly journals Analysis of recipient and graft survival after primary and second kidney transplantation

2021 ◽  
Vol 23 (2) ◽  
pp. 21-29
Author(s):  
A. V. Pinchuk ◽  
N. V. Shmarina ◽  
I. V. Dmitriev ◽  
V. E. Vinogradov ◽  
A. I. Kazantsev
Keyword(s):  
Kidney Transplantation ◽  
Graft Survival ◽  
Survival Rates ◽  
Term Survival ◽  
Kidney Recipients ◽  
Significant Difference ◽  
History Of ◽  
First Time ◽  
Older Recipients

Objective: to evaluate the 1- and 5-year graft and recipient survival after primary and second kidney transplantation, to compare the outcomes depending on the age of recipients.Material and methods. The treatment outcomes for 364 patients who underwent kidney transplantation at Sklifosovsky Research Institute of Emergency Care, Moscow over the period from 2007 to 2019. Of these, 213 patients underwent kidney transplantation for the first time, while 151 patients were having a second transplantation. We analyzed the effect of previous transplants, as well as the age of the recipients on long-term survival rates.Results. No significant difference in 1- and 5-year survival of kidney recipients after primary and second transplantations was found. In contrast, the long-term graft survival significantly depended on this criterion and turned out to be significantly higher after primary transplantations. The 1- and 5-year survival of older recipients was lower than the survival of younger recipients after primary and second kidney transplantation. The 1-year graft survival after primary kidney transplantation was higher in young recipients than in older recipients of the same group, however, but there were no significant differences in the 5-year graft survival. After second transplantations, there were no significant differences in the 1- and 5-year graft survival depending on the age of recipients.Conclusion. A history of previous transplantation is an important factor in kidney transplantation outcome, which must be taken into account in clinical practice.

scholarly journals Dual kidney transplantation offers a safe and effective way to use kidneys from deceased donors older than 70 years

2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Kyo Won Lee ◽  
Jae Berm Park ◽  
So Ra Cha ◽  
Seo Hee Lee ◽  
Young Jae Chung ◽  
...  
Keyword(s):  
Risk Factors ◽  
Kidney Transplantation ◽  
Serum Creatinine ◽  
Survival Rates ◽  
Donor Pool ◽  
Expanded Criteria ◽  
Deceased Donors ◽  
Expanded Criteria Donors ◽  
Single Kidney

Abstract Purpose Dual kidney transplantation (DKT) offers a way to extend the use of kidneys from expanded criteria donors (ECDs). Here, we compared the outcomes of DKT with those of single kidney transplantation from standard criteria donors (SCDs) and ECDs. Methods In 2014, we began performing DKT using both kidneys from deceased donors greater than 70 years of age with one of two risk factors: serum creatinine (sCr) level over 3.0 mg/dl or eGFR under 30 ml/min. By 2017, we had performed 15 DKTs. We compared the outcomes of the 15 DKT recipients with those of 124 patients who received a kidney from an SCD and 80 patients who received a kidney from an ECD. Results Compared with ECDs and SCDs, DKT donors were older, had a higher diabetes burden, and a higher sCr level (p < 0.01, < 0.01, and 0.03, respectively). DKT recipients were also older and had a higher diabetes burden than recipients of kidneys from ECDs and SCDs (p < 0.01, both). DKT recipients had a lower nadir sCr and shorter duration to nadir sCr than single ECD KT recipients (p < 0.01and 0.04, respectively). Conclusions The survival rates of DKT grafts were compatible with those of single KT grafts. Therefore, DKT may be considered a suitable an option to expand the donor pool.

scholarly journals The Value of Graft Implantation Sequence in Simultaneous Pancreas-Kidney Transplantation on the Outcome and Graft Survival

2021 ◽  
Vol 10 (8) ◽  
pp. 1632
Author(s):  
Hans-Michael Hau ◽  
Nora Jahn ◽  
Sebastian Rademacher ◽  
Elisabeth Sucher ◽  
Jonas Babel ◽  
...  
Keyword(s):  
Kidney Transplantation ◽  
Graft Survival ◽  
Graft Function ◽  
Kidney Graft ◽  
Significant Difference ◽  
Pancreas Kidney Transplantation ◽  
Simultaneous Pancreas Kidney ◽  
Graft Implantation ◽  
Simultaneous Pancreas Kidney Transplantation ◽  
Pancreas Graft

Background/Objectives: The sequence of graft implantation in simultaneous pancreas-kidney transplantation (SPKT) warrants additional study and more targeted focus, since little is known about the short- and long-term effects on the outcome and graft survival after transplantation. Material and methods: 103 patients receiving SPKT in our department between 1999 and 2015 were included in the study. Patients were divided according to the sequence of graft implantation into pancreas-first (PF, n = 61) and kidney-first (KF, n = 42) groups. Clinicopathological characteristics, outcome and survival were reviewed retrospectively. Results: Donor and recipient characteristics were similar. Rates of post-operative complications and graft dysfunction were significantly higher in the PF group compared with the KF group (episodes of acute rejection within the first year after SPKT: 11 (18%) versus 2 (4.8%); graft pancreatitis: 18 (18%) versus 2 (4.8%), p = 0.04; vascular thrombosis of the pancreas: 9 (14.8%) versus 1 (2.4%), p = 0.03; and delayed graft function of the kidney: 12 (19.6%) versus 2 (4.8%), p = 0.019). The three-month pancreas graft survival was significantly higher in the KF group (PF: 77% versus KF: 92.1%; p = 0.037). No significant difference was observed in pancreas graft survival five years after transplantation (PF: 71.6% versus KF: 84.8%; p = 0.104). Kidney graft survival was similar between the two groups. Multivariate analysis revealed order of graft implantation as an independent prognostic factor for graft survival three months after SPKT (HR 2.6, 1.3–17.1, p = 0.026) and five years (HR 3.7, 2.1–23.4, p = 0.040). Conclusion: Our data indicates that implantation of the pancreas prior to the kidney during SPKT has an influence especially on the early-post-operative outcome and survival rate of pancreas grafts.

scholarly journals Trends in the Management and Outcomes of Kidney Transplantation for Autosomal Dominant Polycystic Kidney Disease

2014 ◽  
Vol 2014 ◽  
pp. 1-7 ◽  
Author(s):  
Madhukar S. Patel ◽  
Praveen Kandula ◽  
David Wojciechowski ◽  
James F. Markmann ◽  
Parsia A. Vagefi
Keyword(s):  
Kidney Transplantation ◽  
Kidney Disease ◽  
Polycystic Kidney Disease ◽  
Graft Survival ◽  
Autosomal Dominant ◽  
Polycystic Kidney ◽  
Significant Difference ◽  
Autosomal Dominant Polycystic Kidney ◽  
One Year ◽  
Late Group

Background.Autosomal dominant polycystic kidney disease (ADPKD) is the most common genetic disorder leading to end-stage renal failure. The objective of this study was to evaluate a longitudinal experience of kidney transplantation for ADPKD.Methods.A single center retrospective review of patients undergoing kidney transplantation was conducted, with comparisons across two time periods: early (02/2000–04/2007,n=66) and late (04/2007–08/2012,n=67).Results.Over the 13.5-year study period, 133 patients underwent transplantation for ADPKD. Overall, no significant difference between the early and late group with regard to intraoperative complications, need for reoperation, readmissions within 30 days, delayed graft function, and mortality was noted. There was a trend towards increase in one-year graft survival (early 93.1% versus late 100%,P=0.05). In the early group, 67% of recipients had undergone aneurysm screening, compared to 91% of recipients in the late group (P<0.001).Conclusions.This study demonstrates consistent clinical care with a trend towards improved rates of one-year graft survival. Interestingly, we also note a significantly higher use of cerebral imaging over time, with the majority that were detected requiring surgical intervention which may justify the current practice of nonselective radiological screening until improved screening criteria are developed.

scholarly journals Immediate outcome and one-year graft survival rate after live related kidney transplantation: experience in a tertiary care hospital of Bangladesh

2021 ◽  
Vol 32 (1) ◽  
pp. 39-42
Author(s):  
Mohammad Mehfuz E Khoda ◽  
Muhammad Abdur Rahim ◽  
Ishrat Jahan Shimu ◽  
Rafi Nazrul Islam ◽  
Md Golzar Hossain ◽  
...  
Keyword(s):  
Renal Function ◽  
Kidney Transplantation ◽  
Survival Rate ◽  
Serum Creatinine ◽  
Graft Survival ◽  
Normal Renal Function ◽  
Survival Rates ◽  
Transplant Recipients ◽  
Kidney Transplant Recipients ◽  
One Year

Background: Renal transplantation remains the treatment of choice for end-stage renal disease, as the procedure not only improves quality of life, but also markedly increases patients’ survival rates. Organ and patient survival rates are important issues of interest post-transplantation.The aims of this study were to analyze the data for immediate post-procedure outcome and one-year graft survival after live related kidney transplantation. Methods:A retrospective study was conducted in Bangladesh Institute of Research and Rehabilitation in Diabetes, Endocrine and Metabolic Disorders (BIRDEM) General Hospital, Dhaka, Bangladesh between November 2004 and September 2019. Data for a total of 132 live related kidney transplant recipients were collected in pre-formed questionnaire from the hospital records. Results:Total patients were 132 including 97 (73.5%) males. Mean age of recipients was 36.8±10.4 years. Mean post-transplantation hospital stay was 13.6±3.4 (range 9 to 30) days. During postoperative hospital stay, 6 (4.6%) patients required haemodialysis due to delayed graft function and high levels of serum creatinine. During discharge, 117 (88.6%) recipients had normal renal function (mean serum creatinine level 1.15±0.21 mg/dl) and 15 (11.4%) patients showed improvement in serum creatinine levels but did not reach normal value (mean serum creatinine levels 3.25±2.35 mg/ dl). All patients were regularly followed-up in post-transplant clinic (3 patients did not complete 1 year) after transplantation. After the first year of kidney transplantation, patient and graft survival rates were 90.7% (117/129) and 82.9% (107/129) respectively. Conclusions: Eighty-eightpercent live related kidney transplant recipients had normal renal function immediate post-surgery and one-year graft survival rate was over eighty percent in this study. Bangladesh J Medicine January 2021; 32(1) : 39-42

A Comparison of Cyclosporin versus Azathioprine Treatment in Renal Transplants in Edinburgh

1989 ◽  
Vol 34 (3) ◽  
pp. 459-462
Author(s):  
A. Notghi ◽  
J. Dick ◽  
G. Smith ◽  
J.L. Anderton ◽  
G.D. Chisholm
Keyword(s):  
Survival Rate ◽  
Graft Survival ◽  
Survival Rates ◽  
Treatment Groups ◽  
Post Transplant ◽  
Cyclosporin Treatment ◽  
Azathioprine Treatment ◽  
Significant Difference ◽  
One Year ◽  
Azathioprine Group

Three year graft survival rates were calculated for 66 patients on cyclosporin and prednisolone immunosuppression and compared to survival rates for 73 patients on azathioprine and prednisolone. There was a temporary early advantage for the cyclosporin treatment group up to four months post transplant. There was no further significant difference between the two treatment groups with graft survival rate of 81.4% in cyclosporin and 76.7% in azathioprine group at three years post transplant. Fewer of the patients on cyclosporin had acute episodes of rejection. There was no significant difference in serum creatinine or urea at one year, but the haemoglobin level was higher in cyclosporin treated patients. Cyclosporin does not appear to have increased the survival rate significantly in our centre where there is already a high graft survival with azathioprine.

scholarly journals The impact of early acute rejection on kidney graft survival after repeat kidney transplantation

2021 ◽  
Vol 13 (3) ◽  
pp. 260-271
Author(s):  
A. V. Pinchuk ◽  
N. V. Shmarina ◽  
I. V. Dmitriev ◽  
E. S. Stolyarevich ◽  
N. V. Natalya V. Zagorodnikova ◽  
...  
Keyword(s):  
Kidney Transplantation ◽  
Acute Rejection ◽  
Graft Survival ◽  
Postoperative Period ◽  
Kidney Graft ◽  
Group I ◽  
Group Ii ◽  
Kidney Transplantations ◽  
The Impact

Introduction. Despite the improvements in immunosuppressive therapy, the growing number of repeat kidney transplantations and associated risks of acute rejection make it relevant to assess the impact of early acute rejection on a long-term kidney graft survival.Objective. The aim of the study was to evaluate the rate, the clinical aspects of early acute rejection after repeat kidney transplantation and the outcomes of its treatment, to perform the assessment of the impact of rejection episodes on a long-term kidney graft survival.Material and methods. We carried out the retrospective analysis of kidney graft survival after 121 repeat kidney transplantations performed in N.V. Sklifosovsky Research Institute for Emergency Medicine in the period from 2007 to 2018. Group I included 96 recipients after kidney transplantation without acute rejection in postoperative period. Group II consisted of 25 patients with early acute rejection after kidney transplantation. We performed the assessment of the impact of early acute rejection on the kidney graft survival in comparison with recipients with uncomplicated postoperative period. Statistical processing was carried out by nonparametric methods. Survival was assessed using the Kaplan–Meier curves.Results. 1-year and 3-year kidney graft survival rates amounted to 90.3% (95%, confidence interval 85–95) and 85.4% (95%, CI 79–91), respectively, in recipients of Group I; and 72% (95%, CI 58–86) and 60% (95%, CI 46–76) in patients of Group II. Significant differences in 1-year and 3-year kidney graft survival between patients of Group I and II have been noticed (P=0.0022 and P=0.0065, respectively).Conclusions. Patients with early acute rejection after kidney transplantation had poorer kidney graft survival in comparison with patients without rejection episodes in postoperative period.

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