scholarly journals Preemptive second kidney transplantation is associated with better graft survival compared with non-preemptive second transplantation: a multicenter French 2000-2014 cohort study

2017 ◽  
Vol 31 (4) ◽  
pp. 408-423 ◽  
Author(s):  
Sophie Girerd ◽  
Nicolas Girerd ◽  
Kevin Duarte ◽  
Magali Giral ◽  
Christophe Legendre ◽  
...  
Author(s):  
Clarisse Grèze ◽  
Bruno Pereira ◽  
Yves Boirie ◽  
Laurent Guy ◽  
Clémentine Millet ◽  
...  

Abstract Background The access of obese patients to kidney transplantation is limited despite several studies showing that obese transplant recipients had a better survival rate than those undergoing dialysis. The aim of this study was to compare patient and graft survival rates and post-renal transplant complications in obese patients and non-obese patients and to assess the effect of pre-transplant weight loss in obese patients on transplant outcomes. Methods We carried out a prospective cohort study using two French registries REIN and CRISTAL on 7 270 kidney transplant patients between 2008 and 2014 in France. We compared obese patients with non-obese patients and obese patients who lost more than 10% of weight before the transplant (Obese WL and Obese nWL). Results The mean BMI in our obese patients was 32 kg/m2. Graft survival was lower in obese patients than in non-obese patients (HR = 1.40, IC 95% [1.09; 1.78], P = 0.007) whereas patient survival was similar (HR = 0.94, IC 95% [0.73; 1.23], P = 0.66). Graft survival was significantly lower in Obese WL than in Obese nWL (HR = 2.17, CI 95% [1.02; 4.63], P = 0.045) whereas patient survival was similar in the two groups (HR = 0.79, IC 95% [0.35; 1.77], P = 0.56). Conclusion Grade I obesity does not seem to be a risk factor for excess mortality after kidney transplantation and should not be an obstacle to having access to a graft. Weight loss before a kidney transplant in this patients should not be essential for registration on waiting list.


2015 ◽  
Vol 65 (1) ◽  
pp. 172-173 ◽  
Author(s):  
Rebecca A. Spicer ◽  
Philip A. Clayton ◽  
Steven J. McTaggart ◽  
Geoff Y. Zhang ◽  
Stephen I. Alexander

2015 ◽  
Vol 15 (9) ◽  
pp. 2378-2386 ◽  
Author(s):  
N. Krishnan ◽  
R. Higgins ◽  
A. Short ◽  
D. Zehnder ◽  
D. Pitcher ◽  
...  

2017 ◽  
Vol 1 (24) ◽  
pp. 2115-2119 ◽  
Author(s):  
Jean Kwun ◽  
Christopher Burghuber ◽  
Miriam Manook ◽  
Brian Ezekian ◽  
Jaeberm Park ◽  
...  

Key Points Targeting both PCs and GC response reduces donor-specific antibodies and prolongs graft survival in sensitized NHP kidney transplantation.


2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Kyeong Deok Kim ◽  
Kyo Won Lee ◽  
Sang Jin Kim ◽  
Okjoo Lee ◽  
Manuel Lim ◽  
...  

AbstractThe use of kidneys from donation after brain death (DBD) donors with acute kidney injury (AKI) is a strategy to expand the donor pool. The aim of this study was to evaluate how kidney transplantation (KT) from a donor with AKI affects long-term graft survival in various situations. All patients who underwent KT from DBD donors between June 2003 and April 2016 were retrospectively reviewed. The KDIGO (Kidney Disease: Improving Global Outcomes) criteria were used to classify donor AKI. The cohort included 376 donors (no AKI group, n = 117 [31.1%]; AKI group n = 259 [68.9%]). Death-censored graft survival was similar according to the presence of AKI, AKI severity, and the AKI trend (p = 0.929, p = 0.077, and p = 0.658, respectively). Patients whose donors had AKI who received using low dose (1.5 mg/kg for three days) rabbit anti-thymocyte globulin (r-ATG) as the induction agent had significantly superior death-censored graft survival compared with patients in that group who received basiliximab (p = 0.039). AKI in DBD donors did not affect long-term death-censored graft survival. Low-dose r-ATG may be considered as an induction immunosuppression in recipients receiving kidneys with AKI because it showed better graft survival than basiliximab.


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