Simultaneous Liver-Kidney Transplantation: What are Our Obligations to the Kidney Only Recipient?

AbstractPurpose of ReviewThere has been a recent explosion in the number of simultaneous liver and kidney (SLK) transplants performed. This practice is crowding out the population of ESRD patients waiting for a kidney transplant.Recent FindingsIt has been alleged from retrospective, anecdotal reports, often from voluntary registries, that there is a survival advantage for those with renal dysfunction that receive an SLK compared to Liver Transplant Alone. However, this survival advantage is quite small —about 5% at 1 and 5 years at best. A new algorithm introduced in 2016 by UNOS may make this problem worse by allowing SLK transplant for patients who may not have permanent kidney failure with a glomerular filtration rate (GFR) as high as 30cm3/min.SummaryThe transplant community needs to have a high degree of vigilance to identify which groups of patients are being disadvantaged when reallocation schemes are created to direct organs from one group to another.
Source: Current Transplantation Reports - Category: Transplant Surgery Source Type: research

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Source: Fight Aging! - Category: Research Authors: Tags: Newsletters Source Type: blogs
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Source: Molecular Genetics and Metabolism - Category: Genetics & Stem Cells Source Type: research
Researchers continue to take incremental steps towards the creation of engineered living tissues containing the vascular networks needed to support it. Absent blood vessels, numerous varieties of functional tissue can be generated from cell samples: lung, liver, kidney, and so forth. These organoids are limited in size to a few millimeters, however, the distance the nutrients and oxygen can perfuse. Generating blood vessel networks is a serious technical challenge, and the major obstacle to the production of entire organs for transplantation. Consider that natural capillary networks exhibit a density of hundreds of vessels...
Source: Fight Aging! - Category: Research Authors: Tags: Daily News Source Type: blogs
3D-printed models of the upper gastrointestinal (GI) tract provided several...Read more on AuntMinnie.comRelated Reading: 3D-printed head customizes neurosurgery simulation How can 3D printing improve kidney cancer surgery? 3D printing enhances chest wall reconstruction 3D printing cuts hip fracture repair time, blood loss 3D printing reduces liver transplant costs, surgery time
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In conclusion, n3-PUFA food supplementation altered the oxylipin levels significantly but did not protect from renal function deterioration or attenuate ischemia induced renal inflammation.
Source: Prostaglandins and Other Lipid Mediators - Category: Lipidology Source Type: research
Ascites is the most common complication of cirrhosis and represents a watershed moment, with patients' median survival falling from>12 years for compensated cirrhosis to approximately 2 years. Treatment aims to reduce sodium intake and increase renal sodium excretion with the aldosterone antagonist spironolactone, starting at 100  mg daily; 60% respond. Renal dysfunction affects as many as 20% of hospitalized patients and is a strong predictor of mortality. Liver transplantation represents the best treatment for hepatorenal syndrome (HRS) yet is rarely available, and a combination of vasoconstrictors and albumin ...
Source: Medicine - Category: Internal Medicine Authors: Tags: Management problems in liver disease Source Type: research
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Source: Journal of Laparoendoscopic - Category: Surgery Authors: Source Type: research
We reported 1 patient with donor-derived CRKP infection following liver transplantation and 2 patients following renal transplantation (1 liver and 2 kidneys were from the same donor), who experienced sudden abdominal pain and abdominal hemorrhage almost at the same time after organ transplantation. Diagnosis: The patients were diagnosed as graft arteries rupture due to corrosion caused by CRKP infection based on computed tomography scan, blood culture, laparotomy, and pulse-field gel electrophoresis. Interventions: Anti-shock treatment, exploratory laparotomy, broad-spectrum antibiotics, and abdominal puncture and d...
Source: Medicine - Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research
The objective of this study was to investigate the association between IPV in tacrolimus exposure and immune-mediated graft injury after liver transplantation. Methods. For 326 liver transplant recipients, transplanted between 2000 and 2015, tacrolimus IPV was calculated from at least 5 tacrolimus trough samples obtained between months 6 and 18 after liver transplantation and expressed as the coefficient of variation. Primary composite endpoint consisted of immune-mediated graft injury (chronic rejection, biopsy proven, and suspected late acute rejection) after month 6. Secondary outcomes were the association between ta...
Source: Transplantation - Category: Transplant Surgery Tags: Original Clinical Science–Liver Source Type: research
Background. Cardiovascular comorbidity is of increasing importance after transplantation. Metabolic syndrome (MS) contributes to the risk for cardiovascular sequelae. Our aim was to assess the risk for MS in pediatric solid organ and stem cell transplant recipients by comparing them with matched untransplanted peers in a multicenter study. Methods. We prospectively assessed MS in 295 pediatric transplant recipients and compared them with 1475 age- and sex-matched controls. Results. Posttransplant metabolic syndrome (PTMS) was most frequent in lung (43%) and kidney (39%), followed by liver (16%) and stem cell (13%) ...
Source: Transplantation - Category: Transplant Surgery Tags: Original Clinical Science–General Source Type: research
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