Living Kidney Donor Criteria Based on Blood Pressure, Body Mass Index, and Glucose: Age-Stratified Decision-Making in the Absence of Hard Data

Abstract Kidney transplantation is the preferred choice for many patients with end-stage renal disease. Long waiting times for deceased donor kidneys and declining health on dialysis remain major barriers. It is within this paradigm that optimal timing of kidney transplantation requires the availability of a living donor. Historically, potential donors were most often young and in excellent health by standards of the time. Accepted values of blood pressure and glucose have become more restrictive in recent decades. Living kidney donation has appeared generally safe but nonetheless carries some surgical and potential long-term risks. Demographic changes with aging and higher obesity rates have challenged transplant centers to reevaluate donor acceptance criteria to consider potential donors with isolated medical abnormalities. We adopted a set of age-based protocols to consider donor risk by incorporating relevant data from studies of the general population. These criteria may potentially allow an older donor to take on some additional risk in the context of both a more established medical history and fewer additional life-years during which that risk might manifest. Herein, we describe our rationale and approach.
Source: Current Transplantation Reports - Category: Transplant Surgery Source Type: research

Related Links:

Authors: Li JS, Li B Abstract Renal failure is one of the most important causes of mortality and morbidity all over the world. Acute kidney injury (AKI) is a major clinical problem that affects up to 5% of all hospitalized patients. Although the kidney has a remarkable capacity for regeneration after acute injury, the mortality among patients with severe AKI remains dismally high, and in clinical practice, most patients cannot be cured completely and suffer from chronic kidney disease (CKD). Recently, the incidence and prevalence of CKD have increased, largely as a result of the enhanced prevalence of diabetes and ...
Source: Advances in Experimental Medicine and Biology - Category: Research Tags: Adv Exp Med Biol Source Type: research
The rising prevalence of obesity is a well known global problem, as is the relationship between obesity and end stage renal disease (ESRD). Even though the best treatment for ESRD is kidney transplantation, haemodialysis, which depends on vascular access, is a key element in the management of ESRD. The first line haemodialysis option with the best short and long term results is the creation of native arteriovenous access (arteriovenous fistula, AVF). Unfortunately, obese patients with ESRD are higher risk of unsuccessful AVF creation due to maturation problems associated with deep veins.
Source: European Journal of Vascular and Endovascular Surgery - Category: Surgery Authors: Tags: Invited Commentary Source Type: research
ConclusionIn DT1 patients, renal transplantation is the best treatment for ESRD despite the use of corticosteroids and anticalcineurins. However, prior explorations of good cardiac function and adequate vascular compliance are essential to reduce the risk of CV.
Source: Archives of Cardiovascular Diseases Supplements - Category: Cardiology Source Type: research
ConclusionThe transplant population has multiple cardiovascular risk factors. Early detection and correction of these factors must be a priority in order to improve the survival of these patients.
Source: Archives of Cardiovascular Diseases Supplements - Category: Cardiology Source Type: research
ConclusionsWe could not find a relationship between serum fetuin-A levels and valvular calcification in kidney recipients. In this population, further studies are needed to assess the role of serum fetuin-A in valvular calcification.
Source: Clinical and Experimental Nephrology - Category: Urology & Nephrology Source Type: research
Fight Aging! provides a weekly digest of news and commentary for thousands of subscribers interested in the latest longevity science: progress towards the medical control of aging in order to prevent age-related frailty, suffering, and disease, as well as improvements in the present understanding of what works and what doesn't work when it comes to extending healthy life. Expect to see summaries of recent advances in medical research, news from the scientific community, advocacy and fundraising initiatives to help speed work on the repair and reversal of aging, links to online resources, and much more. This content is...
Source: Fight Aging! - Category: Research Authors: Tags: Newsletters Source Type: blogs
Giuseppe Ristagno1*, Francesca Fumagalli1, Barbara Bottazzi2, Alberto Mantovani2,3,4, Davide Olivari1, Deborah Novelli1 and Roberto Latini1 1Department of Cardiovascular Research, Mario Negri Institute for Pharmacological Research IRCCS, Milan, Italy 2Humanitas Clinical and Research Center-IRCCS, Milan, Italy 3Humanitas University, Milan, Italy 4The William Harvey Research Institute, Queen Mary University of London, London, United Kingdom The long pentraxin PTX3 is a member of the pentraxin family produced locally by stromal and myeloid cells in response to proinflammatory signals and microbial moieties. The p...
Source: Frontiers in Immunology - Category: Allergy & Immunology Source Type: research
In this study, we investigated the genetic contribution to renal disease in Tiwi Islanders by conducting a GWAS, in which associations were tested between SNP genetic variants and single measure ACR levels. A number of nominally significantly associated SNPs were identified. These SNPs did not reach genome wide significance, probably due to the small sample size. The top eight SNPs were re-tested for association in a separately collected cohort from the same population. Four of these SNPs were significantly associated with ACR in the replication sample (p
Source: Frontiers in Genetics - Category: Genetics & Stem Cells Source Type: research
A drug that’s used to help control blood sugar in people with diabetes has now been shown to help prevent or slow kidney disease, which causes millions of deaths each year and requires hundreds of thousands of people to use dialysis to stay alive. Doctors say it’s hard to overstate the importance of this study, and what it means for curbing this problem, which is growing because of the obesity epidemic. The study tested Janssen Pharmaceuticals’ drug Invokana. Results were discussed Sunday at a medical meeting in Australia and published by the New England Journal of Medicine. About 30 million Americans and...
Source: TIME: Health - Category: Consumer Health News Authors: Tags: Uncategorized medicine onetime overnight Source Type: news
Abstract There is clear evidence that survival rates following transplantation far exceed those for remaining on dialysis, regardless of body size measured by body mass index (BMI). Studies over the past 15 years also suggest little to no difference in long-term outcomes, including graft survival and mortality, irrespective of BMI, in contrast to earlier evidence. However, weight bias still exists, as access to kidney transplantation remains inequitable in centers using arbitrary BMI limits. Clinicians faced with the decision regarding listing based on body size are not helped by conflicting recommendations i...
Source: Seminars in Dialysis - Category: Urology & Nephrology Authors: Tags: Semin Dial Source Type: research
More News: Dialysis | Eating Disorders & Weight Management | Health | Kidney Transplant | Kidney Transplantation | Obesity | Study | Transplant Surgery | Transplants | Urology & Nephrology | Waiting Times