scholarly journals The history of renal transplantation in Canada

2020 ◽  
Vol 14 (12) ◽  
Author(s):  
Max Alexander Levine ◽  
Joseph L. Chin ◽  
Andrew Rasmussen ◽  
Alp Sener ◽  
Patrick Luke
Keyword(s):  
Kidney Transplantation ◽  
Renal Transplantation ◽  
Kidney Transplant ◽  
Professional Group ◽  
History Of ◽  
The Impact

While the urologist’s involvement in kidney transplantation varies from center to center and country to country, urologists remain integral to many programs across Canada. From the early days of kidney transplant to contemporary times, the leadership, vision, and skillset of Canadian urologists have helped progress the field. In this review of Canadian urologists’ role in kidney transplantation, the achievements of this professional group are highlighted and celebrated. Original contributors to the field, as well as notable achievements are highlighted, with a focus on the impact of Canadian urologists.

scholarly journals Implementation of a Quality Improvement Strategy to Increase Outpatient Kidney Transplant Referrals

2020 ◽  
Author(s):  
Samira Farouk ◽  
Sarah Atallah ◽  
Kirk N Campbell ◽  
Joseph A Vassalotti ◽  
Jaime Uribarri
Keyword(s):  
Quality Improvement ◽  
Kidney Transplantation ◽  
Kidney Transplant ◽  
Outpatient Setting ◽  
Improvement Strategy ◽  
Quality Improvement Strategy ◽  
Important Barrier ◽  
Transplant Evaluation ◽  
End Stage ◽  
The Impact

Abstract Background: Kidney transplantation remains the optimal therapy for patients with end stage kidney disease (ESKD), though a small fraction of patients on dialysis are on organ waitlists. An important barrier to preemptive kidney transplantation and successful waitlisting is timely referral to a kidney transplant center. We implemented a quality improvement strategy to improve outpatient kidney transplant referrals in a single center academic outpatient nephrology clinic. Methods: Over a 3 month period (July 1 - September 30, 2016), we assessed the baseline kidney transplantation referral rate at our outpatient nephrology clinic for patients 18 - 75 years old with an estimated glomerular filtration rate (eGFR) of less than 20 mL/min/1.73m 2 (2 values over 90 days apart). Charts were manually reviewed by two reviewers to look for kidney transplant referrals and documentation of discussions about kidney transplantation. We then performed a root cause analysis to explore potential barriers to kidney transplantation. Our intervention began on July 1, 2017 and included the implementation of a column in the electronic medical record (EMR) which displayed the patient's last eGFR as part of the clinic schedule. Physicians were given a document listing their patients to be seen that day with an eGFR of < 20 mL/min/1.73m 2 . Results: 54 unique patients with eGFR ≤ 20 ml/min/1.73 m 2 were identified who were seen in the Clinic between July 1, 2016 and September 30, 2016. 29.6% (16) eligible patients were referred for kidney transplantation evaluation. 69.5% (37) of these patients were not referred for kidney transplant evaluation. 46.3% (25) did not have documentation regarding kidney transplant in the EMR. Following the intervention, 66 unique patients met criteria for eligibility for kidney transplant evaluation. Kidney transplant referrals increased to 60.6% (p < 0.001). Conclusions: Our pilot implementation study of a strategy to improve outpatient kidney transplant referrals showed that a free, simple, scalable intervention can significantly improve kidney transplant referrals in the outpatient setting Next steps include further study of the impact of early referral to kidney transplant centers on preemptive and living donor kidney transplantation as well as successful waitlisting.

scholarly journals Donor genetic variants in interleukin-6 and interleukin-6 receptor associate with biopsy-proven rejection following kidney transplantation.

2021 ◽  
Author(s):  
Felix Poppelaars ◽  
Mariana Gaya da Costa ◽  
Siawosh K. Eskandari ◽  
Jeffrey Damman ◽  
Marc A. Seelen
Keyword(s):  
Kidney Transplantation ◽  
Renal Transplantation ◽  
Renal Transplant ◽  
Interleukin 6 ◽  
Medical Center ◽  
Organ Donors ◽  
Nucleotide Polymorphisms ◽  
Increased Risk ◽  
Major Player ◽  
The Impact

Rejection after kidney transplantation remains an important cause of allograft failure that markedly impacts morbidity. Cytokines are a major player in rejection, and we, therefore, explored the impact of interleukin-6 (IL6) and IL-6 receptor (IL6R) gene polymorphisms on the occurrence of rejection after renal transplantation. We performed an observational cohort study analyzing both donor and recipient DNA in 1,271 renal transplant-pairs from the University Medical Center Groningen in The Netherlands and associated single nucleotide polymorphisms (SNPs) with biopsy-proven rejection after kidney transplantation. The C-allele of the IL6R SNP (Asp358Ala: rs2228145 A>C, formerly rs8192284) in donor kidneys conferred a reduced risk of rejection following renal transplantation (HR 0.78 per C-allele; 95%-CI 0.67-0.90; P=0.001). On the other hand, the C-allele of the IL6 SNP (at position-174 in the promoter; rs1800795 G>C) in donor kidneys was associated with an increased risk of rejection for male organ donors (HR per C-allele 1.31; 95%-CI 1.08-1.58; P=0.0006), but not female organ donors (P=0.33). In contrast, neither the IL6 nor IL6R SNP in the recipient showed an association with renal transplant rejection. In conclusion, donor IL6 and IL6R genotypes but not recipient genotypes represent an independent prognostic marker for biopsy-proven renal allograft rejection.

scholarly journals La terapia immunosoppressiva nel trapianto di rene

2019 ◽  
Vol 31 (3) ◽  
pp. 192-196
Author(s):  
Aris Tsalouchos ◽  
Maurizio Salvadori
Keyword(s):  
Kidney Transplantation ◽  
Renal Transplantation ◽  
Acute Rejection ◽  
Immunosuppressive Therapy ◽  
Kidney Transplant ◽  
Induction Therapy ◽  
Immunosuppressive Agents ◽  
Oral Prednisone ◽  
Kidney Transplant Recipients ◽  
Optimal Maintenance

Immunosuppressive therapy in renal transplantation Immunosuppressive therapy in renal transplantation can be distinguished in induction therapy and maintenance therapy. Induction therapy is an intense immunosuppressive therapy administered at the time of kidney transplantation to reduce the risk of acute allograft rejection. In general, the induction immunosuppressive strategies used at kidney transplant centers fall into one of these two categories. One strategy relies upon high doses of conventional immunosuppressive agents, while the other utilizes antibodies directed against T-cell antigens in combination with lower doses of conventional agents. Maintenance immunosuppressive therapy is administered to almost all kidney transplant recipients to help prevent acute rejection and loss of the renal allograft. Although an adequate level of immunosuppression is required to dampen the immune response to the allograft, the level of chronic immunosuppression is decreased over time (as the risk of acute rejection decreases) to help lower the overall risk of infection and malignancy; these risks directly correlate with the degree of overall immunosuppression. The optimal maintenance immunosuppressive therapy in kidney transplantation is not established. The major immunosuppressive agents that are available in various combination regimens are glucocorticoids (primarily oral prednisone), azathioprine, mycophenolate mofetil (MMF), enteric-coated mycophenolate sodium (EC-MPS), cyclosporine (in non-modified or modified [microemulsion] form), Tacrolimus, everolimus, rapamycin (sirolimus), and Belatacept.

scholarly journals 50-year history of kidney transplantation in Hungary

2013 ◽  
Vol 154 (22) ◽  
pp. 846-849 ◽  
Author(s):  
Edit Szederkényi ◽  
Pál Szenohradszky ◽  
Ernő Csajbók ◽  
Ferenc Perner ◽  
László Asztalos ◽  
...  
Keyword(s):  
Kidney Transplantation ◽  
Kidney Transplant ◽  
Graft Rejection ◽  
Full Membership ◽  
Ministry Of Health ◽  
The Past ◽  
Transplant Program ◽  
History Of ◽  
Patient Groups ◽  
Special Patient

The first Hungarian kidney transplantation was performed by András Németh in Szeged in 1962, approximately 50 years ago. A preliminary agreement with Eurotransplant was signed in 2011, and special patient groups gained benefit from this cooperation in 2012, wnich lead to a full membership to Eurotransplant. This event inspired the authors to review the history of Hungarian kidney transplantation of the past 50 years, from the first operation to recent via the specific cornerstones of the transplant program. The donor of the first Hungarian kidney transplantation was the brother of the recipient. The operation itself was technically successful, but the lack of immunosuppression caused graft rejection, and the patient died after 79 days. His brother, the donor, is still healthy, after 50 years, and he encourages everybody to donate organs. Organized kidney transplant program started more than 10 years later, such as 1973, in Budapest. The program was supported by the Ministry of Health. New centers joined the program later, Szeged in 1979, Debrecen in 1991 and Pécs in 1993. These four transplant centers work currently in Hungary, and 6611 kidney transplantation has been performed up to the end of year 2012. Orv. Hetil., 2013, 154, 846–849.

scholarly journals A functional TGFB1 polymorphism in the donor associates with long-term graft survival after kidney transplantation.

2021 ◽  
Author(s):  
Felix Poppelaars ◽  
Mariana Gaya da Costa ◽  
Bernardo Faria ◽  
Siawosh K. Eskandari ◽  
Jeffrey Damman ◽  
...  
Keyword(s):  
Kidney Transplantation ◽  
Kidney Transplant ◽  
Graft Survival ◽  
Graft Loss ◽  
Kidney Graft ◽  
Genotype Group ◽  
Transplant Survival ◽  
Increased Risk ◽  
The Impact

Introduction Improvement of long-term outcomes in kidney transplantation remains one of the most pressing challenges, yet drug development is stagnating. Human genetics offers an opportunity for much-needed target validation in transplantation. Conflicting data exists about the effect of transforming growth factor beta 1 (TGF-beta1) on kidney transplant survival, since TGF-beta1 has profibrotic and protective effects. We therefore the impact of a recently discovered functional TGBF1 polymorphism on long term kidney graft survival. Methods We performed an observational cohort study analyzing recipient and donor DNA in 1,271-kidney transplant pairs from the University Medical Center Groningen in The Netherlands and associated a low-producing TGBF1 polymorphism (rs1800472 C>T) with 5, 10, and 15-year death-censored kidney graft survival. Results Donor genotype frequencies of s1800472 in TGBF1 differed significantly between patients with and without graft loss (P=0.042). Additionally, the low-producing TGBF1 polymorphism in the donor was associated with an increased risk of graft loss following kidney transplantation (HR 2.13 for the T allele; 95%-CI 1.16-3.90; P=0.015). The incidence of graft loss within 15 years of follow-up was 16.4% in the CC-genotype group and 28.9% in the CT-genotype group. After adjustment for transplant-related covariates, the association between the TGBF1 polymorphism in the donor and graft loss remained significant. In contrast, there was no association between the TGBF1 polymorphism in the recipient and graft loss. Conclusion Kidney allografts possessing a low-producing TGBF1 polymorphism have a higher risk of late graft loss. Our study adds to a growing body of evidence that TGFbeta1 is beneficial, rather than harmful, for kidney transplant survival.

scholarly journals A Case Report on Post-Transplant Erythrocytosis

2019 ◽  
Vol 9 (2) ◽  
pp. 170-173
Author(s):  
Mohammad Mehfuz E Khoda ◽  
Ishrat Jahan Shimu ◽  
Md Golzar Hossain ◽  
Mirza Shariful Haque ◽  
Moontasim Akhter Moon ◽  
...  
Keyword(s):  
Kidney Transplantation ◽  
Case Report ◽  
Renal Transplantation ◽  
Transplant Recipient ◽  
Haemoglobin Level ◽  
Kidney Transplant Recipient ◽  
Post Transplant ◽  
History Of ◽  
High Haematocrit ◽  
Uncommon Complication

Post-transplant erythrocytosis is defined as persistently elevated haemoglobin and haematocrit levels that occur following renal transplantation and persist for more than six months in the absence of thrombocytosis, leukocytosis or other potential causes of erythrocytosis. Here, we report the case history of a 35-year-old male, who underwent live related kidney transplantation ten months ago, presented with high haemoglobin level and high haematocrit. It is an uncommon complication of kidney transplant recipient,whichprompted us to report the case Birdem Med J 2019; 9(2): 170-173

scholarly journals Acute Renal Failure and Volume Overload Syndrome Secondary to a Femorofemoral Arteriovenous Fistula Angioplasty in a Kidney Transplant Recipient

2013 ◽  
Vol 2013 ◽  
pp. 1-3
Author(s):  
Dominique Bertrand ◽  
Geoffroy Desbuissons ◽  
Nicolas Pallet ◽  
Albane Sartorius ◽  
Christophe Legendre ◽  
...  
Keyword(s):  
Renal Failure ◽  
Kidney Transplantation ◽  
Transplant Recipient ◽  
Kidney Transplant ◽  
Kidney Function ◽  
Clinical Symptoms ◽  
Kidney Transplant Recipient ◽  
Volume Overload ◽  
Kidney Transplant Recipients ◽  
The Impact

Experimental and clinical studies analyzing the impact of AVF on cardiovascular and renal parameters, as well as outcomes, in kidney transplant recipients are lacking. On the other hand, it is not known whether AVF ligation after transplantation modifies hemodynamic parameters and kidney function. We report a case of a renal transplant recipient who developed an acute congestive heart failure accompanied by renal failure, which were triggered by femorofemoral AVF angioplasty. Prompt AVF ligation rapidly reversed clinical symptoms and normalized cardiac and renal functions. This paper illustrates the potential deleterious consequences of high-output AVF after kidney transplantation and raises considerations regarding the impact of the fistula on cardiac status and kidney function after kidney transplantation and, consequently, the management AVF after transplantation.

scholarly journals Donor genetic variants in interleukin-6 and interleukin-6 receptor associate with biopsy-proven rejection following kidney transplantation

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Felix Poppelaars ◽  
Mariana Gaya da Costa ◽  
Siawosh K. Eskandari ◽  
Jeffrey Damman ◽  
Marc A. Seelen
Keyword(s):  
Kidney Transplantation ◽  
Renal Transplantation ◽  
Renal Transplant ◽  
Interleukin 6 ◽  
Medical Center ◽  
Organ Donors ◽  
Nucleotide Polymorphisms ◽  
Increased Risk ◽  
Major Player ◽  
The Impact

AbstractRejection after kidney transplantation remains an important cause of allograft failure that markedly impacts morbidity. Cytokines are a major player in rejection, and we, therefore, explored the impact of interleukin-6 (IL6) and IL-6 receptor (IL6R) gene polymorphisms on the occurrence of rejection after renal transplantation. We performed an observational cohort study analyzing both donor and recipient DNA in 1271 renal transplant‐pairs from the University Medical Center Groningen in The Netherlands and associated single nucleotide polymorphisms (SNPs) with biopsy-proven rejection after kidney transplantation. The C-allele of the IL6R SNP (Asp358Ala; rs2228145 A > C, formerly rs8192284) in donor kidneys conferred a reduced risk of rejection following renal transplantation (HR 0.78 per C-allele; 95%-CI 0.67–0.90; P = 0.001). On the other hand, the C-allele of the IL6 SNP (at position-174 in the promoter; rs1800795 G > C) in donor kidneys was associated with an increased risk of rejection for male organ donors (HR per C-allele 1.31; 95%-CI 1.08–1.58; P = 0.0006), but not female organ donors (P = 0.33). In contrast, neither the IL6 nor IL6R SNP in the recipient showed an association with renal transplant rejection. In conclusion, donor IL6 and IL6R genotypes but not recipient genotypes represent an independent prognostic marker for biopsy-proven renal allograft rejection.

scholarly journals Grupo de orientação multiprofissional para pacientes transplantados renais e familiares

2021 ◽  
Vol 11 (34) ◽  
pp. 296-306
Author(s):  
Beatriz Pinheiro da Mota Costa ◽  
Alessandra Rosa Vicari ◽  
Carla Elisabete da Silva Oliveira ◽  
Fernanda Guarilha Boni ◽  
Isabel Cristina Echer
Keyword(s):  
Kidney Transplantation ◽  
Kidney Transplant ◽  
Personal Growth ◽  
Family Members ◽  
Structured Interview ◽  
University Hospital ◽  
Transplant Patients ◽  
Group I ◽  
Kidney Transplant Patients ◽  
The Impact

Conhecer a percepção de pacientes e familiares acerca do grupo de orientação multiprofissional para transplantados renais. Método: trata-se de um estudo qualitativo realizado em hospital universitário do sul do Brasil nos meses de fevereiro a maio do ano de 2019. As informações foram coletadas pelos pesquisadores por meio de entrevista estruturada com os participantes do grupo de orientação multiprofissional. Foi realizada a técnica de análise de conteúdo. Resultados: participaram 15 pacientes transplantados renais e quatro familiares. A análise dos depoimentos resultou em três categorias: “Motivação para participar do grupo”, “Sou transplantado renal, e agora?” e “Compreendendo as orientações: o impacto no autocuidado”. As orientações em grupo foram consideradas objetivas, claras e relevantes para a recuperação. Considerações finais: participar do grupo possibilitou estreitamento de laços familiares/profissionais, crescimento pessoal, maior conhecimento sobre o transplante renal, mudança de comportamento e comprometimento com o autocuidado.Descritores: Enfermagem, Transplante de Rim, Equipe de Assistência ao Paciente, Educação em Saúde. Multiprofessional guidance group for kidney and family transplant patientsAbstract: To know the perception of patients and family members about the multiprofessional guidance group for kidney transplant patients. Method: this is a qualitative study carried out at a university hospital in southern Brazil from February to May of 2019. The information was collected by the researchers through a structured interview with the participants of the multiprofessional guidance group. The content analysis technique was performed. Results: 15 kidney transplant patients and four family members participated. The analysis of the testimonies resulted in three categories: “Motivation to participate in the group”, “I am a kidney transplanted, what now?” and “Understanding the guidelines: the impact on self-care”. The group guidelines were considered objective, clear and relevant to recovery. Final considerations: to participate in the group allowed for closer family/professional ties, personal growth, greater knowledge about kidney transplantation, behavior change and commitment to self-care.Descriptors: Nursing, Kidney Transplantation, Patient Care Team, Health Education. Grupo de orientación multiprofesional para pacientes con trasplante renal y familiarResumen: Conocer la percepción de los pacientes y familiares sobre el grupo de orientación multiprofesional para pacientes con trasplante renal. Método: es un estudio cualitativo realizado en un hospital universitario del sur de Brasil de febrero a mayo de 2019. La información fue recolectada por los investigadores mediante una entrevista estructurada con los participantes del grupo de orientación multiprofesional. Se realizó la técnica de análisis de contenido. Resultados: participaron 15 pacientes con trasplante renal y cuatro familiares. El análisis de los testimonios resultó en tres categorías: “Motivación para participar en el grupo”, “Soy un trasplante de riñón, ¿ahora qué?” y “Comprender las pautas: el impacto en el autocuidado”. Las pautas del grupo se consideraron objetivas, claras y relevantes para la recuperación. Consideraciones finales: participar en el grupo permitió estrechar lazos familiares/profesionales, crecimiento personal, mayor conocimiento sobre trasplante de riñón, cambio de comportamiento y compromiso con el autocuidado.Descriptores: Enfermería, Trasplante de Riñón, Grupo de Atención al Paciente, Educación en Salud.

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