Novel Approaches to Expanding Benefits from Living Kidney Donor Chains

AbstractPurpose of ReviewAlthough allocation strategies such as kidney paired donation (KPD) have helped to enhance transplant opportunities for immunologically incompatible recipient and donor pairs, further expansion and optimization of KPD is possible. This review examines Global Kidney Exchange and Deceased Donors as Chain-Initiating Kidneys, two novel strategies aimed to expand the benefits of KPD.Recent FindingsGlobal Kidney Exchange offers the opportunity to utilize the mechanism of kidney exchange to overcome financial barriers to kidney transplantation, thus increasing the pool of participating pairs, unlocking more chains, avoiding costs from dialysis, and expanding kidney transplantation to serve impoverished patients. The Deceased Donors as Chain-Initiating Kidneys strategy aims to increase matching opportunities by using deceased donor kidneys to initiate KPD chains.SummaryWe find that both ideas offer the promise of more kidney transplants and a reduction in the personal and economic burden caused by ESRD.
Source: Current Transplantation Reports - Category: Transplant Surgery Source Type: research

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We examined the role of iron deficiency and inflammation in RLS in pediatric CKD.Methods:This cross-sectional study examined RLS prevalence in three groups of pediatric patients with CKD: nontransplant, nondialysis CKD (estimated GFR
Source: Journal of Clinical Sleep Medicine : JCSM - Category: Sleep Medicine Source Type: research
Donate Life America is now in partnership with a large dialysis corporation to expand living donor resources for waiting recipients on the kidney transplant list.Medscape Medical News
Source: Medscape Medical News Headlines - Category: Consumer Health News Tags: Nephrology News Source Type: news
We report a high vertebral fracture prevalence and incidence in transplantation-eligible patients on dialysis, suggesting that these patients may benefit from radiographic screening for vertebral fractures. Parathyroid hormone had a U-shaped association with vertebral fracture risk.IntroductionVertebral fractures are often overlooked, but even undiagnosed vertebral fractures negatively impact physical functioning, quality of life, and mortality. The risk of vertebral fractures in end-stage renal disease (ESRD) patients is unclear, and parathyroid hormone (PTH) might play a role in the development of vertebral fractures. We...
Source: Osteoporosis International - Category: Orthopaedics Source Type: research
This article explains the motivation for ambulatory hemodialysis and provides an overview of the necessary features of key technologies that will be the basis for new wearable and implantable devices. Early work by pioneers of hemodialysis is described followed by recent experience using a wearable unit on patients. Finally, ongoing efforts to develop an implantable device for kidney replacement and its potential for implantable hemodialysis are presented. PMID: 31727617 [PubMed - as supplied by publisher]
Source: Clinical Journal of the American Society of Nephrology : CJASN - Category: Urology & Nephrology Authors: Tags: Clin J Am Soc Nephrol Source Type: research
Surgeons at the Cleveland Clinic managed to implant a donor kidney into a patient using a surgical robot, and all through one small incision. The technique, in which instruments as well as the donor kidney can be passed through a four centimeter (1.6...
Source: Medgadget - Category: Medical Devices Authors: Tags: Surgery Urology Source Type: blogs
ConclusionsMarked differences in risk for ESKD across types of donor-recipient relationship were observed for Asian, black, and white donors. These findings warrant further validation with more robust data to better inform clinical practice guidelines.
Source: American Journal of Kidney Diseases - Category: Urology & Nephrology Source Type: research
We report on the prespecified secondary outcome, echocardiographic indexes of LV function, from a previously reported study of the effect of lung ultrasound (US)-guided dry weight reduction on systolic blood pressure.Study DesignSingle-blind randomized trial.Settings &Participants71 clinically euvolemic hypertensive hemodialysis patients in Greece and Slovenia.InterventionThe active intervention group’s (n = 35) volume removal was guided by the total number of lung US B-lines observed every week before a midweek dialysis session. The usual-care group (n = 36) was treated using standard-of-care...
Source: American Journal of Kidney Diseases - Category: Urology & Nephrology Source Type: research
In this study, our aim was to verify whether dialysis type determined outcomes on the pancreas graft and whether dialysis type was a risk factor for graftectomy or recipient death. MATERIALS AND METHODS: Our study group included 44 simultaneous pancreas and kidney transplant patients. Analyzed parameters included type and duration of dialysis treatment, age, sex, long-term pancreas graft survival and patient survival, overall mortality, and number of graftectomies. RESULTS: Of 44 patients, 3 (7%) required a graftectomy. Mortality rate of the group was 5%. Of 44 patients, 33 had hemodialysis and 11 had peritoneal ...
Source: Experimental and Clinical Transplantation : official journal of the Middle East Society for Organ Transplantation - Category: Transplant Surgery Authors: Tags: Exp Clin Transplant Source Type: research
Abstract In the future, stem cell-based technologies may be harnessed to replace conventional dialysis and transplantation in patients with diabetic nephropathy. Recently, there has been considerable effort to improve methods for the differentiation of human pluripotent stem cells (hPSCs) into kidney cells in culture. Here, we present a protocol for obtaining more advanced kidney structures than have currently been possible in vitro, including vascularized glomeruli and tubular elements. HPSCs are first differentiated in 2D culture to a kidney progenitor stage. These cells are then dissociated and injected subcuta...
Source: Mol Biol Cell - Category: Molecular Biology Authors: Tags: Methods Mol Biol Source Type: research
ConclusionOur study showed excellent efficacy with the safety profile of this drug combination in End Stage Renal Disease patients. However, larger prospective studies and multicenter randomized controlled trials are needed for further confirmation.
Source: Journal of Clinical and Experimental Hepatology - Category: Gastroenterology Source Type: research
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