Varicella Zoster Virus Serostatus Before and After Kidney Transplantation, and Vaccination of Adult Kidney Transplant Candidates

2006 ◽  
Vol 38 (10) ◽  
pp. 3418-3419 ◽  
Author(s):  
A.L. Geel ◽  
T.S. Landman ◽  
J.A. Kal ◽  
G.J. van Doomum ◽  
W. Weimar
Keyword(s):  
Kidney Transplantation ◽  
Varicella Zoster Virus ◽  
Kidney Transplant ◽  
Varicella Zoster ◽  
Adult Kidney ◽  
Before And After ◽  
Transplant Candidates

scholarly journals Abdominal Panniculectomy Can Simplify Kidney Transplantation in Obese Patients

2021 ◽  
pp. 1-8
Author(s):  
Dominik Promny ◽  
Theresa Hauck ◽  
Aijia Cai ◽  
Andreas Arkudas ◽  
Katharina Heller ◽  
...  
Keyword(s):  
Wound Healing ◽  
Kidney Transplantation ◽  
Postoperative Complications ◽  
Kidney Transplant ◽  
Interdisciplinary Approach ◽  
Wound Complications ◽  
Obese Patients ◽  
Patient Cohort ◽  
Transplant Candidates ◽  
Stage Renal Disease

<b><i>Background:</i></b> Obesity is frequently present in patients suffering from end-stage renal disease (ESRD). However, overweight kidney transplant candidates are a challenge for the transplant surgeon. Obese patients tend to develop a large abdominal panniculus after weight loss creating an area predisposed to wound-healing disorders. Due to concerns about graft survival and postoperative complications after kidney transplantation, obese patients are often refused in this selective patient cohort. The study aimed to analyze the effect of panniculectomies on postoperative complications and transplant candidacy in an interdisciplinary setting. <b><i>Methods:</i></b> A retrospective database review of 10 cases of abdominal panniculectomies performed in patients with ESRD prior to kidney transplantation was conducted. <b><i>Results:</i></b> The median body mass index was 35.2 kg/m<sup>2</sup> (range 28.5–53.0 kg/m<sup>2</sup>) at first transplant-assessment versus 31.0 kg/m<sup>2</sup> (range 28.0–34.4 kg/m<sup>2</sup>) at panniculectomy, and 31.6 kg/m<sup>2</sup> (range 30.3–32.4 kg/m<sup>2</sup>) at kidney transplantation. We observed no major postoperative complications following panniculectomy and minor wound-healing complications in 2 patients. All aside from 1 patient became active transplant candidates 6 weeks after panniculectomy. No posttransplant wound complications occurred in the transplanted patients. <b><i>Conclusion:</i></b> Abdominal panniculectomy is feasible in patients suffering ESRD with no major postoperative complications, thus converting previously ineligible patients into kidney transplant candidates. An interdisciplinary approach is advisable in this selective patient cohort.

scholarly journals Analysis of the physical aspects of quality of life of kidney recipients

2015 ◽  
Vol 49 (1) ◽  
pp. 76-81 ◽  
Author(s):  
Ana Elza Oliveira de Mendonça ◽  
Marina de Góes Salvetti ◽  
Eulália Maria Chaves Maia ◽  
Ana Cristina de Oliveira e Silva ◽  
Gilson de Vasconcelos Torres
Keyword(s):  
Quality Of Life ◽  
Kidney Transplantation ◽  
Kidney Transplant ◽  
World Health ◽  
Need For Treatment ◽  
Kidney Recipients ◽  
Quality Of Life Scale ◽  
Before And After ◽  
Health Organization

OBJECTIVE To identify the main factors of the physical domain modified after kidney transplantation and analyze the influence of those aspects in the perception of Overall quality of life (QOL). METHOD Longitudinal study, conducted with 63 chronic kidney patients, evaluated before and after kidney transplant, using the quality of life scale proposed by the World Health Organization. RESULTS We observed significant improvement in the physical aspects of QOL after kidney transplantation. Significant correlations were observed between physical aspects and the Overall QOL. CONCLUSION The kidney transplant generated improvement in all physical aspects of QOL. The factors that showed stronger correlation with the Overall QOL before the transplant were the capacity to work and pain. After the transplant, the perception of need for treatment was the factor that showed stronger correlation with the Overall QOL.

scholarly journals Cognitive Function, Access to Kidney Transplantation, and Waitlist Mortality Among Kidney Transplant Candidates With or Without Diabetes

2020 ◽  
Vol 76 (1) ◽  
pp. 72-81 ◽  
Author(s):  
Nadia M. Chu ◽  
Zhan Shi ◽  
Christine E. Haugen ◽  
Silas P. Norman ◽  
Alden L. Gross ◽  
...  
Keyword(s):  
Kidney Transplantation ◽  
Cognitive Function ◽  
Kidney Transplant ◽  
Transplant Candidates ◽  
Waitlist Mortality

MANAGEMENT OF HYPERPARATHYROIDISM IN KIDNEY TRANSPLANTATION CANDIDATES: A NEED FOR CONSENSUS

2020 ◽  
Vol 26 (3) ◽  
pp. 299-304 ◽  
Author(s):  
Hubert Golingan ◽  
Shenae K. Samuels ◽  
Pauline Camacho ◽  
Darshana M. Dadhania ◽  
Fernando E. Pedraza-Taborda ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Transplantation ◽  
Parathyroid Hormone ◽  
Kidney Disease ◽  
Kidney Transplant ◽  
American Association ◽  
The United States ◽  
Standards Of Care ◽  
Endocrine Surgery ◽  
Transplant Candidates

Objective: To assess the evolving standards of care for hyperparathyroidism in kidney transplant candidates. Methods: An 11-question, Institutional Review Board–approved survey was designed and reviewed by multiple institutions. The questionnaire was made available to the American Society of Transplantation's Kidney Pancreas Community of Practice membership via their online hub from April through July 2019. Results: Twenty percent (n = 41) of kidney transplant centers responded out of 202 programs in the United States. Forty-one percent (n = 17) of respondents believed medical literature supports the concept that a serum parathyroid hormone level greater than 800 pg/mL could endanger the survival of a transplanted kidney and therefore makes transplantation in an affected patient relatively or absolutely contraindicated. Sixty-six percent (n = 27) said they occasionally recommend parathyroidectomy for secondary hyperparathyroidism prior to transplantation, and 66% (n = 27) recommend parathyroidectomy after transplantation based on persistent, unsatisfactory posttransplantation parathyroid hormone levels. Forty-six percent (n = 19) prefer subtotal parathyroidectomy as their choice; 44% (n = 18) had no standard preference. Endocrine surgery and otolaryngology were the most common surgical specialties consulted to perform parathyroidectomy in kidney transplant candidates. The majority of respondents (71%, n = 29) do not involve endocrinologists in the management of kidney transplantation candidates. Conclusion: Our survey shows wide divergence of clinical practice in the area of surgical management of kidney transplantation candidates with hyperparathyroidism. We suggest that medical/surgical societies involved in the transplantation care spectrum convene a multidisciplinary group of experts to create a new section in the kidney transplantation guidelines addressing the collaborative management of parathyroid disease in transplantation candidates. Abbreviations: AACE = American Association of Clinical Endocrinologists; AAES = American Association of Endocrine Surgeons; AHNS = American Head and Neck Society; CKD = chronic kidney disease; CKD-MBD = chronic kidney disease–mineral and bone disorder; ESRD = end-stage renal disease; HPT = hyperparathyroidism; KDIGO = Kidney Disease Improving Global Outcomes; KT = kidney transplantation; KTC = kidney transplant candidate; PTH = parathyroid hormone; PTX = parathyroidectomy; US = ultrasonography

scholarly journals Frailty and Access to Kidney Transplantation

2019 ◽  
Vol 14 (4) ◽  
pp. 576-582 ◽  
Author(s):  
Christine E. Haugen ◽  
Nadia M. Chu ◽  
Hao Ying ◽  
Fatima Warsame ◽  
Courtenay M. Holscher ◽  
...  
Keyword(s):  
Kidney Transplantation ◽  
Confidence Interval ◽  
Kidney Transplant ◽  
Proportional Hazards ◽  
Cox Proportional Hazards ◽  
Activity Level ◽  
Frailty Status ◽  
Poor Cognitive Function ◽  
Transplant Candidates ◽  
Poor Outcomes

Background and objectivesFrailty, a syndrome distinct from comorbidity and disability, is clinically manifested as a decreased resistance to stressors and is present in up to 35% of patient with ESKD. It is associated with falls, hospitalizations, poor cognitive function, and mortality. Also, frailty is associated with poor outcomes after kidney transplant, including delirium and mortality. Frailty is likely also associated with decreased access to kidney transplantation, given its association with poor outcomes on dialysis and post-transplant. Yet, clinicians have difficulty identifying which patients are frail; therefore, we sought to quantify if frail kidney transplant candidates had similar access to kidney transplantation as nonfrail candidates.Design, setting, participants, & measurementsWe studied 7078 kidney transplant candidates (2009–2018) in a three-center prospective cohort study of frailty. Fried frailty (unintentional weight loss, grip strength, walking speed, exhaustion, and activity level) was measured at outpatient kidney transplant evaluation. We estimated time to listing and transplant rate by frailty status using Cox proportional hazards and Poisson regression, adjusting for demographic and health factors.ResultsThe mean age was 54 years (SD 13; range, 18–89), 40% were women, 34% were black, and 21% were frail. Frail participants were almost half as likely to be listed for kidney transplantation (hazard ratio, 0.62; 95% confidence interval, 0.56 to 0.69; P<0.001) compared with nonfrail participants, independent of age and other demographic factors. Furthermore, frail candidates were transplanted 32% less frequently than nonfrail candidates (incidence rate ratio, 0.68; 95% confidence interval, 0.58 to 0.81; P<0.001).ConclusionsFrailty is associated with lower chance of listing and lower rate of transplant, and is a potentially modifiable risk factor.

scholarly journals P1622GROWTH DIFFERENTIATION FACTOR 15: A BIOMARKER WITH HIGH CLINICAL POTENTIAL IN THE EVALUATION OF KIDNEY TRANSPLANT CANDIDATES

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Marina De Cos Gomez ◽  
Adalberto Benito Hernandez ◽  
M Angeles Ramos Barron ◽  
Covadonga Lopez del Moral Cuesta ◽  
Jaime Mazon Ruiz ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Kidney Transplantation ◽  
Coronary Artery ◽  
High Risk ◽  
Vascular Disease ◽  
Kidney Transplant ◽  
Enzyme Linked Immunosorbent Assay ◽  
Differentiation Factor ◽  
Artery Disease ◽  
Transplant Candidates

Abstract Background and Aims Kidney transplantation results a significant improvement in patient survival. Nevertheless, mortality the first years after transplant remains relatively high, being mostly related to cardiovascular (CV) events. The selection of patients for kidney transplantation includes a general assessment focused on CV status. In spite of that, due to the complexity and heterogeneity of mechanisms leading to vascular disease in this population (not exclusively related to traditional CV risk factors and pathogenesis), this evaluation remains insufficient and not particularly effective. During the last years different strategies have been studied to stratify potential receptors better and optimize organ allocation, including the development of clinical prognostic scores and novel biomarkers. Growth differentiation factor 15 (GDF-15) is a stress-responsive member of the TGF-β family. Although its mechanism of action is not completely understood, it acts as a cytokine with effects in regulation of inflammation, metabolism and senescence. In the recent years, interest has arisen regarding its use as a biomarker for diagnosis, prognosis and risk stratification in multiple scenarios. Encouraging results have shown its utility as a biomarker of mortality (all cause and CV), heart failure and acute coronary syndrome in different populations. The aim of this work is to assess the utility of GDF-15 to predict survival in kidney transplant candidates. Method 395 kidney transplant recipients between 2005 and 2015 were included. GDF-15 measurements were performed from stored serum samples obtained pretransplant. The concentration of GDF-15 was analyzed using an enzyme-linked immunosorbent assay (Quantikine, R&D Systems). Results Patient characteristics are shown in Table 1. The median GDF-15 was 5331.3 (50.49-16242.3) pg/ml. After a mean of 90.6 ± 41.5 months of follow up 82 (20.8%) patients died. Patients were stratified in tertiles according to GDF-15 levels: low (GDF-15 ≤ 4612.1 pg/ml), medium (GDF-15 4612.1-6296.5 pg/ml) and high risk tertile (GDF-15 &gt; 6296.5 pg/ml). Higher GDF-15 concentrations were significantly associated with mortality: HR 2.16 95%CI (1.14-1.44), p = 0.018 for medium tertile and HR 3.28 95%CI (1.79-6.1), p &lt;0.001 for high risk tertile (Figure 1). After adjusting for age, diabetes, coronary artery disease, peripheral vascular disease, non-renal solid organ transplant and dialysis at the time of transplant, the relation between survival and GDF-15 was significant (HR 2.24 95%CI (1.2-4.16), p = 0.011 for high risk tertile). After adjusting by EPTS (Estimated Post Transplant Survival score) the association with GDF-15 remained significant: HR 3.24 95%CI (1.2-8.8), p = 0.021 for medium risk tertile and HR 4.3 95%CI (1.65-11.54), p = 0.003 for high risk tertile (calculated only in first renal transplants). Mortality at 3 years was 6.9% (27 patients) and it was only related to coronary artery disease and GDF-15 (OR 7.1 95%CI (1.6-32.1), p = 0.01 for high risk tertile) after adjustment. Conclusion In our cohort, higher GDF-15 levels were independently associated with mortality in kidney transplant candidates. This study suggests that GDF-15 may be useful in stratifying recipient risk, adding value to the prognostic tools already available in clinical practice. Further work is needed to confirm these findings and elucidate the mechanisms linking this protein with mortality and CV disease in patients with CKD.

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