scholarly journals Machine Retrograde Perfusion of Deceased Donor Kidneys: A Prospective Study

2021 ◽  
Vol 8 ◽  
Author(s):  
Jun Zeng ◽  
ZiHao Jia ◽  
Tao Lin ◽  
TuRun Song
Keyword(s):  
Estimated Glomerular Filtration Rate ◽  
Graft Function ◽  
Deceased Donor ◽  
Control Group ◽  
Lower Serum ◽  
Safe Alternative ◽  
Kidney Preservation ◽  
Retrograde Perfusion ◽  
Deceased Donors ◽  
A Prospective Study

Objective: To maximize the utilization of potential kidneys, improving perfusion and preservation techniques is necessary.Methods: We investigated the safety and efficacy of retrograde machine perfusion of kidneys from deceased donors. A total of 30 kidneys were included and all the grafts were preserved in the Kidney Transporter machines. A total of 15 kidneys that received retrograde perfusion (RP) were selected as the RP group (n = 15) and their counterparts received standard antegrade perfusion (AP) as the control group (n = 15).Results: All the recipients were followed up for 6 months. Renal resistance in the RP group remained stable during the perfusion. There was no primary nonfunction. No difference in the incidence of delayed graft function was found in both groups (3 in RP vs. 2 in AP, p = 0.62). The RP group had lower serum creatinine (RP vs. AP, 102.20 vs. 138.67, p = 0.05) and blood urea nitrogen (RP vs. AP, 6.44 vs. 8.71, p = 0.05) than that in the AP group at 6 months. Both the groups had comparable estimated glomerular filtration rate and cystatin C within 6 months.Conclusion: This novel technique may be an effective and safe alternative for kidney preservation.

scholarly journals Results of Deceased Donor Kidney Transplantation in Young Recipients after Age-matched and Mismatched (Old-to-young) Transplantation

2016 ◽  
Vol 16 (2) ◽  
pp. 8-11
Author(s):  
Janis Jushinskis ◽  
Vadims Suhorukovs ◽  
Aleksandrs Malcevs ◽  
Ieva Ziedina ◽  
Rafails Rozentals
Keyword(s):  
Graft Function ◽  
Deceased Donor ◽  
Rejection Rate ◽  
Donor Age ◽  
Donor Kidney ◽  
Deceased Donor Kidney ◽  
Significant Difference ◽  
Deceased Donors ◽  
Kidney Transplantations

SummaryIntroduction.During the previous years the number of organ transplantations from elderly donors increased, and lack of young donors leads to necessity to allocate organs from elderly into young recipients.Aim of the Study.Was to analyse results of “old-to-young” allocation.Material and methods.This retrospective study analysed results of all consecutive deceased donor kidney transplantations (DDKT) performed in one transplant centre during the period from 01.01.2004 till 31.12.2007. Patients were selected based on availability of 5-year follow-up and age < 50 years (158 DDKT). Patients were divided into 2 groups according to donor age: age-mismatched group (donor age was > 55 years and at the same time > 15 years older than recipient; n=8, male/female=2/6, age 39,4 + 4,8 years, donor age 59,4 + 2,4 years), and age-matched group (n=150, male/female=88/62, age 36,0 + 11,0 years, donor age 37,3 + 12,0 years). Groups were compared for clinical and demographical features and posttransplant outcomes (delayed graft function, s-creatinin levels at discharge and after 5 years, acute rejection rate, graft and patient 5-year survival).Results.Comparison of demographical and clinical features revealed only relatively higher BMI in elderly donors (p=0.081) and higher frequency of age-mismatched allocation into female recipients (p=0.066). Early and late post-transplant outcomes showed no significant difference between groups, with similar 5-year graft and patient survival (p=NS for all compared factors).Conclusion.Results showed good kidney allograft function even in cases of age-mismatched allocation, which is significant opportunity in current situation with increasing age of deceased donors.

Nationwide Outcomes after Renal Transplantation from Kidney-Only versus Multiple-Organ Deceased Donors

2019 ◽  
Vol 85 (9) ◽  
pp. 1066-1072
Author(s):  
Gianna D. Katsaros ◽  
Jessica Schucht ◽  
Christopher M. Jones ◽  
Robert M. Cannon
Keyword(s):  
Cumulative Incidence ◽  
Patient Survival ◽  
Graft Loss ◽  
Graft Function ◽  
Deceased Donor ◽  
Multiple Organ ◽  
Donation After Cardiac Death ◽  
Propensity Matching ◽  
Deceased Donors ◽  
United Network

To assess renal transplant outcomes after donation by kidney-only (KO) versus multiple-organ (MO) donors on a national scale. The United Network for Organ Sharing database was examined for patients undergoing isolated kidney transplant from a deceased donor from 2000 through 2016. Comparison was made between recipients of grafts from KO versus MO donors at baseline and in a cohort of KO and MO recipients matched via propensity scoring. Outcomes of interest included delayed graft function (DGF), patient survival, and the cumulative incidence of graft loss. There were 33,326 recipients in the KO cohort versus 144,690 in the MO cohort. Donation after cardiac death donors were more prevalent in the KO group (43.8% vs 5.3%; P < 0.001). DGF occurred in 36.1 per cent of the KO versus 22.7 per cent of the MO recipients ( P < 0.001). Five-year survival was 79.5 per cent versus 83.4 per cent ( P < 0.001) in the KO versus MO group. After propensity matching, DGF was still more common in the KO group (33.1% vs 30.1%; P < 0.001). Patient survival was similar (79.5% KO vs 80.1% MO; P = 0.117). Cumulative incidence of graft loss was higher in the KO group (17.8% vs 16.8%). Survival outcomes from KO donors are actually quite good and should not be considered as inferior to MO donors.

scholarly journals Delayed Renal Graft Function in the Early Post-Transplant Period and its Impact on the Late Post-Transplant Results

2013 ◽  
Vol 67 (1) ◽  
pp. 19-23
Author(s):  
Jānis Jušinskis ◽  
Diāna Amerika ◽  
Aleksandrs Maļcevs
Keyword(s):  
Negative Impact ◽  
Graft Function ◽  
Deceased Donor ◽  
Late Results ◽  
Control Group ◽  
Post Transplantation ◽  
Post Transplant ◽  
Renal Graft ◽  
Renal Grafts ◽  
The Impact

Delayed renal graft function (DGF) is a frequent complication with negative impact on the course of early post-transplantation period. The data concerning the impact on the late results are contradictory. This study describes results of 5-year follow-up of 248 recipients after deceased donor renal transplantation. All patients were divided into two groups: with delayed graft function (DGF, n = 53) and immediate graft function, considered as the control group (IGF, n = 195). We evaluated factors that were associated with development of DGF and its impact on the survival of graft and recipient, and frequency of acute rejections and chronic dysfunctions. The rate of observed DGF was 21.4%. Its development was associated with the following factors: age of recipient and their weight, age of donor and their body mass index, high frequency of asystole/hypotension in donors prior to organ explantation (P < 0.05 for all), and longer time of cold ischemia (P = 0.058). The DGF group had higher rate of acute rejections (P < 0.001), and also lower 1.5 and 5-year graft survival and 1.5-year patient survival (P < 0.05 for all). The conclusion is that DGF has negative impact on the survival of renal grafts and patients, especially during the first 1.5 years after transplantation.

Cold ischemic injury of transplanted kidneys: new insights from experimental studies

2004 ◽  
Vol 287 (2) ◽  
pp. F181-F187 ◽  
Author(s):  
Abdulla K. Salahudeen
Keyword(s):  
Graft Function ◽  
Experimental Studies ◽  
Ischemic Injury ◽  
Deceased Donor ◽  
Definitive Treatment ◽  
Deceased Donors ◽  
Apoptotic Pathways ◽  
Stage Renal Disease ◽  
End Stage ◽  
Transplanted Kidneys

Kidney transplantation is the preferred and definitive treatment for end-stage renal disease (ESRD), and kidneys from deceased donors are a major source for it. These kidneys are routinely cold stored to prolong viability, which, however, when prolonged can cause injury, resulting in reduced graft function and survival. Recent experimental studies have identified the release of iron and free radicals, activation of calpain, and formation of F2-isoprostanes as important components of cold ischemic injury, as are the swelling of mitochondria and activation of mitochondrial apoptotic pathways. Moreover, studies have also suggested that fortifying the storage solution with deferoxamine or preconditioning the donor kidneys with hemeoxygenase-1 may prove viable clinical strategies to limit cold ischemic injury. This review will summarize these and other new experimental data that have implications for reducing cold ischemic transplant injury, a step necessary to improve deceased-donor allograft survival.

Rate, Factors, and Outcome of Delayed Graft Function After Kidney Transplantation of Deceased Donors

2021 ◽  
Author(s):  
Laura Jahn ◽  
Christiane Rüster ◽  
Mandy Schlosser ◽  
Yvonne Winkler ◽  
Susan Foller ◽  
...  
Keyword(s):  
Kidney Transplantation ◽  
Graft Function ◽  
Delayed Graft Function ◽  
Deceased Donors

scholarly journals How Did Prenatal Education Impact Women’s Perception of Pregnancy and Postnatal Life in a Romanian Population

Medicina ◽  
2021 ◽  
Vol 57 (6) ◽  
pp. 581
Author(s):  
Anca Maria Balasoiu ◽  
Octavian Gabriel Olaru ◽  
Romina Marina Sima ◽  
Liana Ples
Keyword(s):  
Prenatal Care ◽  
Newborn Care ◽  
Control Group ◽  
Postnatal Life ◽  
Study Group ◽  
Prenatal Education ◽  
Questionnaire Online ◽  
A Prospective Study ◽  
The Impact ◽  
Official Information

Background and Objectives: Prenatal education represents an important part of maternal prenatal care in Western countries. In Romania, prenatal education is of recent interest but there is no official information about prenatal courses and their impact on prenatal care and patients in Romania. Material and methods: A prospective study based on the STROBE statement was designed in order to assess the prenatal education delivered in our unit. The study group included women who gave birth at Bucur Maternity, “Saint. John” Hospital, Bucharest, Romania and attended the prenatal courses, compared with a control group (women who gave birth in our unit but did not attend the prenatal lecture). Patients’ perception about the impact of prenatal education was collected by applying a questionnaire. Results: The analysis included 89 women who fulfilled the questionnaire online. In our study, 62 women (69.7%) attended the prenatal education classes and represented the study group while 27 women (30.3%) constituted the control group. Women who attended the prenatal lecture recognized the utility of the topic regarding newborn care (90.3%), while women from the control group did not consider it useful (n = 55.6%), χ2 = 18.412, p < 0.001. Patients from the study group admitted the importance of the topics (93.5%) from the lectures about breast feeding, while the percentage of these women from the control group is significantly lower (55.6%) χ2 = 27.867, p < 0.001. Conclusions: The benefits of prenatal education were recognized by women who attended the prenatal lecture, while women who did not participate underestimated the utility of the topics. Further actions are required to inform mothers about the necessity of antenatal education.

scholarly journals Activation of final complement components after kidney transplantation as a marker of delayed graft function severity

2020 ◽  
Author(s):  
Carlos E Arias-Cabrales ◽  
Marta Riera ◽  
María José Pérez-Sáez ◽  
Javier Gimeno ◽  
David Benito ◽  
...  
Keyword(s):  
Epithelial Cells ◽  
Graft Function ◽  
Basal Membrane ◽  
Factor H ◽  
Delayed Graft Function ◽  
Control Group ◽  
Complement Factor ◽  
Tubular Epithelial Cells ◽  
Complement Components ◽  
Protocol Biopsies

Abstract Background Ischaemia–reperfusion (I/R) damage is a relevant cause of delayed graft function (DGF). Complement activation is involved in experimental I/R injury, but few data are available from kidney transplant (KT) patients. We studied the dynamics of membrane attack complex (C5b-9) as a soluble fraction (SC5b-9) and the histological deposit pattern of C3b, complement Factor H (FH) and C5b-9 in DGF patients. Methods We evaluated SC5b-9 levels in 59 recipients: 38 with immediate graft function and 21 with DGF. The SC5b-9 was measured at admission for KT and 7 days after KT. DGF-kidney biopsies (n = 12) and a control group of 1-year protocol biopsies without tissue damage (n = 4) were stained for C5b-9, C3b and FH. Results SC5b-9 increased significantly in DGF patients (Day 0: 6621 ± 2202 mAU/L versus Day 7: 9626 ± 4142  mAU/L; P = 0.006), while it remained stable in non-DGF patients. Days 0–7 increase &gt;5% was the better cut-off associated with DGF versus non-DGF patient discrimination (sensitivity = 81%). In addition, SC5b-9 increase was related to DGF duration and worse graft function, and independently associated with DGF occurrence. SC5b-9, C3b and FH stains were observed in tubular epithelial cells basal membrane. DGF-kidney biopsies showed a more frequently high-intensity stain, a higher number of tubules with positive stain and larger perimeter of tubules with positive stains for SC5b-9, C3b and FH than control patients. Conclusions Both SC5b-9 levels and SC5b-9, C3b and FH deposits in tubular epithelial cells basal membrane are highly expressed in patients experiencing DGF. SC5b-9 levels increase could be useful as a marker of DGF severity.

scholarly journals ENDOSCOPIC AND HISTOPATHOLOGIC GASTRIC CHANGES IN CHRONIC USERS OF PROTON-PUMP INHIBITORS

2015 ◽  
Vol 52 (1) ◽  
pp. 59-64 ◽  
Author(s):  
Sílvia Maria Perrone CAMILO ◽  
Élia Cláudia de Souza ALMEIDA ◽  
Benito André Silveira MIRANZI ◽  
Juliano Carvalho SILVA ◽  
Rosemary Simões NOMELINI ◽  
...  
Keyword(s):  
Proton Pump Inhibitors ◽  
Proton Pump ◽  
Serum Levels ◽  
Control Group ◽  
Upper Gastrointestinal Endoscopy ◽  
Positive Serology ◽  
Cell Hyperplasia ◽  
Sydney System ◽  
A Prospective Study ◽  
Histopathologic Findings

Background Proton-pump inhibitors have been used for at least two decades. They are among the most commonly sold drugs in the world. However, some controversy remains about the indications for their use and the consequences of their prolonged use. Objectives To evaluate and compare the endoscopic and histopathologic gastric changes in chronic users of proton-pump inhibitors to changes in non-users. Methods A prospective study performed at a tertiary Public Hospital involving 105 patients undergoing upper-gastrointestinal endoscopy. Subjects included 81 proton-pump inhibitor users and 24 non-users (control group). Biopsies of the antral-type mucosa, the antral-fundic transition, and the fundus were evaluated by the Sydney System. The presence of erosion or ulceration, lymphatic follicles, reactive gastropathy, and polypoid or epithelial hyperplasia was also determined. Serum levels of gastrin were measured. Results We found two polyps, one in each group, both of which were negative for Helicobacter pylori. There were two cases of parietal cell hyperplasia in users of proton-pump inhibitors. Gastrin was elevated in 28 users of proton-pump inhibitors and in four members of the control group. We did not find statistically significant differences in the endoscopic or histopathologic findings between the two groups. Conclusions Chronic use of proton-pump inhibitors for the duration examined was not associated with significant gastric changes. An interesting finding was that the 4 chronic users of proton-pump inhibitors who had serum gastrin levels above 500 pg/mL also had positive serology for Chagas disease.

scholarly journals Gene Expression Profile in Delay Graft Function: Inflammatory Markers Are Associated with Recipient and Donor Risk Factors

2014 ◽  
Vol 2014 ◽  
pp. 1-9 ◽  
Author(s):  
Diego Guerrieri ◽  
Luis Re ◽  
Jorgelina Petroni ◽  
Nella Ambrosi ◽  
Roxana E. Pilotti ◽  
...  
Keyword(s):  
Gene Expression ◽  
Risk Factors ◽  
Kidney Transplantation ◽  
Inflammatory Markers ◽  
Graft Function ◽  
Deceased Donor ◽  
Specific Pattern ◽  
Inflammatory Gene Expression ◽  
Inflammatory Gene ◽  
Recipient Age

Background.Delayed graft function (DGF) remains an important problem after kidney transplantation and reduced long-term graft survival of the transplanted organ. The aim of the present study was to determine if the development of DGF was associated with a specific pattern of inflammatory gene expression in expanded criteria of deceased donor kidney transplantation. Also, we explored the presence of correlations between DGF risk factors and the profile that was found.Methods.Seven days after kidney transplant, a cDNA microarray was performed on biopsies of graft from patients with and without DGF. Data was confirmed by real-time PCR. Correlations were performed between inflammatory gene expression and clinical risk factors.Results.From a total of 84 genes analyzed, 58 genes were upregulated while only 1 gene was downregulated in patients with DGF compared with no DGF (P=0.01). The most relevant genes fold changes observed was IFNA1, IL-10, IL-1F7, IL-1R1, HMOX-1, and TGF-β. The results were confirmed for IFNA1, IL-1R1, HMOX-1 and TGF-β. A correlation was observed between TGF-β, donor age, and preablation creatinine, but not body mass index (BMI). Also, TGF-βshowed an association with recipient age, while IFNA1 correlated with recipient BMI. Furthermore, TGF-β, IFNA1 and HMOX-1 correlated with several posttransplant kidney function markers, such as diuresis, ultrasound Doppler, and glycemia.Conclusions.Overall, the present study shows that DGF is associated with inflammatory markers, which are correlated with donor and recipient DGF risk factors.

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