Outcomes From Right Versus Left Deceased-Donor Kidney Transplants: A US National Cohort Study

Publication date: Available online 5 December 2019Source: American Journal of Kidney DiseasesAuthor(s): Sanjay Kulkarni, Guo Wei, Wei Jiang, Licia A. Lopez, Chirag R. Parikh, Isaac E. HallRationale &ObjectiveThere may be important transplant-related differences between right and left kidneys, including logistical/surgical considerations about vessel length for the right compared to the left kidney from the same donor. Because US centers choose between the right and left kidney when their recipient is ranked higher on a “match-run,” we sought to determine whether deceased-donor right kidneys have had worse posttransplantation outcomes than left kidneys.Study DesignPaired Organ Procurement and Transplantation Network analysis.Setting &ParticipantsDeceased-donor kidney pairs transplanted during 1990 to 2016.ExposureRight versus left kidney controlling for other significant factors.OutcomesDelayed graft function (DGF), all-cause and death-censored graft failure, and mortality.Analytical ApproachMultivariable conditional logistic regression for DGF; proportional hazards models (conditional on same donor) for failure/mortality with right kidneys (operationalized as 6-month time-varying coefficients) adjusting for DGF and other confounders.Results87,112 recipient pairs shared the following donor characteristics: mean age of 41 ± 14 years, 60% males, and 11% with cardiac death. Recipient characteristics were numerically similar by donor kidney side but...
Source: American Journal of Kidney Diseases - Category: Urology & Nephrology Source Type: research

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The recent article by Hicks et  al1 is very helpful in clarifying the long-standing debate concerning arteriovenous (AV) access ligation following successful kidney transplantation. The authors found that AV access ligation is uncommon in the United States, is not associated with post-transplantation allograft failure, and offer ed no reduction in all-cause mortality. They concluded that AV access ligation should be reserved for access-related complications, such as dialysis access-associated hand ischemia.
Source: Journal of Vascular Surgery - Category: Surgery Authors: Tags: Letter to the Editor Source Type: research
Around 850 million people currently are affected by different types of kidney disorders.1 Up to 1 in 10 adults worldwide has chronic kidney disease (CKD), which is invariably irreversible and mostly progressive. The global burden of CKD is increasing, and CKD is projected to become the fifth most common cause of years of life lost globally by 2040.2 If CKD remains uncontrolled and if the affected person survives the ravages of cardiovascular and other complications of the disease, CKD progresses to end-stage kidney disease, where life cannot be sustained without dialysis therapy or kidney transplantation.
Source: Kidney International - Category: Urology & Nephrology Authors: Tags: Editorial Source Type: research
A 72-year-old man was admitted to the hospital with diabetic ketoacidosis and acute kidney injury 3 months after receiving a deceased-donor kidney transplant. He had undergone induction immunosuppression with rabbit-antithymocyte globulin and took tacrolimus and mycophenolic acid for maintenance immunosuppression. Twelve days prior to admission to the hospital, right knee pain and swelling developed. Synovial fluid was aspirated and showed a white blood cell count of 1825, 61% polymorphonuclear neutrophils, and monosodium urate crystals visualized by polarizing light microscopy.
Source: Kidney International - Category: Urology & Nephrology Authors: Tags: Make Your Diagnosis Source Type: research
AbstractAcute kidney injury (AKI) after hematopoietic stem cell transplantation (HSCT) is associated with high mortality rates. To determine the incidence and risk factors associated with AKI in patients undergoing HSCT during the infusion period, patients admitted for HSCT from 2012 to 2015 were studied. AKI was classified according to the KDIGO (Kidney Disease Improving Global Outcomes) criteria. We analyzed the main comorbidities, underlying conditions, types of transplant, preparative regimens, and use of potentially nephrotoxic drugs as risk factors for AKI. Among the 180 patients (median age 53  years), 69 (36.5...
Source: Annals of Hematology - Category: Hematology Source Type: research
Those who consume up to 20 drinks per week are less likely to develop chronic kidney disease than never drinkers, but authors warn"potential benefits" of alcohol must be weighed against"harms."Medscape Medical News
Source: Medscape Transplantation Headlines - Category: Transplant Surgery Tags: Nephrology News Source Type: news
Could this novel intervention help improve immunosuppressive medication adherence among adult kidney transplant recipients?American Journal of Transplantation
Source: Medscape Today Headlines - Category: Consumer Health News Tags: Transplantation Journal Article Source Type: news
CONCLUSION: Patients with high pre-KT IgG isoagglutinin titers had equally successful outcomes as those with low IgG titers. ABO-i KT can be successfully performed by reducing the pre-KT IgM isoagglutinin titer to 4 or less, as determined by the immediate spin tube method. PMID: 31957888 [PubMed - as supplied by publisher]
Source: Transfusion - Category: Hematology Authors: Tags: Transfusion Source Type: research
Publication date: Available online 16 January 2020Source: American Journal of Kidney DiseasesAuthor(s): Jelmer K. Humalda, Gerald Klaassen, Hanne de Vries, Yvette Meuleman, Lara C. Verschuur, Elisabeth J.M. Straathof, Gozewijn D. Laverman, Willem Jan W. Bos, Paul J.M. van der Boog, Karin M. Vermeulen, Olivier A. Blanson Henkemans, Wilma Otten, Martin H. de Borst, Sandra van Dijk, Gerjan J. Navis, P.J.M. van der Boog, S. van Dijk, G.J. Navis, J.K. Humalda (project coordination), G. KlaassenRationale &ObjectivePatients with chronic kidney disease (CKD) are particularly sensitive to dietary sodium. We evaluated a self-man...
Source: American Journal of Kidney Diseases - Category: Urology & Nephrology Source Type: research
ConclusionsEndoscopic treatment of symptomatic VUR in transplanted kidney is a safe and feasible procedure. The amount of bulking agent or duration between the transplantation and diagnosis of VUR does not have any impact on the success of the treatment. However, the younger age of the patients and the female gender seem to have a positive effect on the outcome of the procedure.
Source: Clinical and Experimental Nephrology - Category: Urology & Nephrology Source Type: research
Abstract BACKGROUND: Proteinuria is common in kidney transplant recipients and has been established as a risk factor for graft-loss and mortality. In the general population, proteinuria has also been tied to a higher risk of cardiovascular disease. There is limited data exploring the association between changes in proteinuria over time and cardiovascular disease in kidney transplant recipients. METHODS: In this retrospective cohort study we evaluated proteinuria as a time-varying covariate using urine dipstick protein values at 6 month intervals post-transplant. The primary outcome was the occurrence a m...
Source: Journal of Nephrology - Category: Urology & Nephrology Authors: Tags: J Nephrol Source Type: research
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