scholarly journals Spontaneous Ureterocolic Fistula between Nonfunctioning Kidney Transplant Ureter and Colon in Setting of Diverticulitis

2021 ◽  
Vol 2021 ◽  
pp. 1-3
Author(s):  
Madison K. Krischak ◽  
Jeffrey R. Ord ◽  
Ashton A. Connor ◽  
Andrew S. Barbas
Keyword(s):  
Kidney Transplantation ◽  
Renal Transplant ◽  
Diverticular Disease ◽  
Sigmoid Colon ◽  
Kidney Transplant ◽  
Rare Condition ◽  
Kidney Transplants

Ureterocolic fistula is a rare condition that most commonly occurs in the setting of diverticular disease. The development of a ureterocolic fistula following kidney transplantation is even rarer, with no prior cases in the literature to our knowledge. We describe the case of a patient with three prior failed kidney transplants who developed a fistula between the sigmoid colon and nonfunctioning renal transplant ureter in the setting of diverticulitis.

scholarly journals Studying Risk Factors Association with Osteoporosis in Post Kidney Transplantation Patients

2020 ◽  
Vol 11 (1) ◽  
pp. 200-206
Author(s):  
Angham Ahmed Hasan ◽  
Munaf H. Zalzala ◽  
Abbas Al-Temimi
Keyword(s):  
Risk Factors ◽  
Kidney Transplantation ◽  
Renal Transplant ◽  
Kidney Transplant ◽  
Female Gender ◽  
Extensive Study ◽  
High Rate ◽  
T Score ◽  
Transplant Patients ◽  
Medical City

Osteoporosis that associate with kidney transplantation is an important cause of ‎morbidity to ‎the patients that warranted extensive study about possible causes of ‎osteoporosis in order to ‎implement several steps to reduce this risk. The current work aimed to investigate possible association between post kidney ‎transplant ‎immunosuppression therapy type and developing the ‎osteoporosis and evaluate the bone mass by using dual X-ray absorptiometry (DXA) post-renalal transplant. A case-control, conducted in kidney transplant center – medical city complex for ‎one year period (‎from October ‎‏2018‏‎ till April 2019), Seventy - five kidney ‎transplant patients were participated in the present study ‎including (21 females & ‎‎54 males). All ‎patients were examined for their bone density using DEXA scan (T – score) and ‎those with cut – point ≤- 2.5 were diagnosed as having osteoporosis (lumber and ‎hip bones were examined). The prevalence of osteoporosis and osteopenia was significantly higher in ‎transplant patients compared to control for bone lumber and hip bone (for ‎lumber bones: 33.3% vs 2.7%l for hip bones: 60% vs. 14.7%). T score was ‎significantly lower in the transplant patients compared to control for both lumber ‎‎(-1.9‎±0.8 vs. -1.1‎±0.7) and hip bones (-2.3‎±0.9 vs -1.3‎±0.8).‎ In logistic regression analysis; only gender and BMI were the predictors of ‎osteoporosis for spinal bone, while; the BMI and calcium were the predictors ‎of osteoporosis for hip bones. In ‏conclusion, Osteoporosis in post-renal transplant patients have a high rate of ‎osteoporosis compared to the general population, post-renal transplant drugs (Cyclosporine, MMF, etc.) did not increase the ‎risk of osteoporosis, and body mass index and female gender were risk factors for osteoporosis

scholarly journals Mathematical аnalysis of kidney transplant demand and availability

2018 ◽  
Vol 19 (4) ◽  
pp. 27-33
Author(s):  
M. G. Minina ◽  
N. A. Ignatov ◽  
S. B. Truhmanov
Keyword(s):  
Kidney Transplantation ◽  
Random Process ◽  
Kidney Transplant ◽  
Process Analysis ◽  
Linear Trend ◽  
Qualitative Change ◽  
Annual Number ◽  
Kidney Transplants ◽  
Saturation Limit ◽  
Number Of Patients

Aim. To analyse the dynamics of the need and availability of donor kidneys for transplantation. To construct the predictions for the number of waiting lists. To analyse the annual number of kidney transplants and the availability ofdonor kidney.Materials and methods. Data base of Eurotransplant International Foundation 1969–2015 has been analyzed. We built a forecast of the kidney waiting list, kidney transplants quantity and availability of kidney grafts up to 2030.Results. Random process analysis of kidney transplant recipients number has shown an increasing linear trend. Growing linear trend is due to the inability to fully meet the increasing need for a kidney transplant. Presence of a regular stochastic component is revealed that provides random fl uctuations in the number of patients waiting for kidney transplantation with a period of 35–40 years. Random process of the number of kidney transplants showed an exponential asymptotic trend growing to a certain saturation value. Estimation of its autocorrelation function showed the absence of regular stochastic components in it. Preservation of 1969–2015 dynamics for the period 2015–2030 allows to suggest a signifi cant increase in the number of people waiting for transplant and a decrease in the availability of donor kidneys.Conclusion. The number of donor kidney transplantations tends to saturation limit, and limit is already lower than the current need for donor kidneys. The increase in the number of kidney transplantation programs and the improvement of organ donation system may lead to a limited increase in annual number of transplants and, possibly, the saturation limit, but not to a qualitative change in the dynamics of reduced availability of donor kidneys. A qualitative change in this dynamics towards increasing accessibility, is possible perhaps through activities that affect factors causing a constant increase in the number of people who need a transplant.

scholarly journals Parvovirus: Uncommon Causes of Anemia and Kidney Failure in a Kidney Transplant Patient

2021 ◽  
Vol In Press (In Press) ◽  
Author(s):  
Maliheh Yarmohamadi ◽  
Fatemeh Yaghoubi
Keyword(s):  
Kidney Transplantation ◽  
Renal Transplant ◽  
Kidney Transplant ◽  
Kidney Failure ◽  
Graft Failure ◽  
Transplant Patient ◽  
Parvovirus B19 ◽  
Kidney Transplant Patient ◽  
Severe Anemia ◽  
Parvovirus B19 Infection

: Parvovirus is one of the uncommon causes of anemia in a kidney transplant patient. We reported a kidney transplant patient with parvovirus infection who developed severe anemia three weeks after kidney transplantation. Suspicion of infections increased due to the decrease in erythrocyte level. The patient's anemia became normal with a decrease in the amount of immunosuppressant and treatment with intravenous immunoglobulin (IVIG). Parvovirus B19 infection should be considered in all patients with persistent anemia with or without graft failure after renal transplant.

scholarly journals Endometriosis in a Renal Transplant Recipient

2020 ◽  
pp. 1-3
Author(s):  
Nizar Attallah ◽  
Ammar Abdulbaki ◽  
Nizar Attallah ◽  
Rakesh Madhyastha ◽  
Sudeendra Gupta
Keyword(s):  
Kidney Transplantation ◽  
Immune System ◽  
Renal Transplant ◽  
Transplant Recipient ◽  
Renal Transplant Recipient ◽  
Kidney Transplant ◽  
Hormonal Therapy ◽  
Kidney Failure ◽  
Menstrual Cycles ◽  
Post Transplant

Hormonal abnormalities that are associated with advanced kidney failure normally reverses after kidney transplantation. This usually helps to normalize menstrual cycles for female patients and helps improve fertility. Post-transplant gynaecological disorders are under-reported in general. We present a patient who developed endometriosis after second kidney transplant. She was treated with surgery followed by hormonal therapy. We discuss the pathophysiology of endometriosis and possible relation to the immune system.

scholarly journals Transition of renal patients using AlloSure® into community kidney care (TRACK): a new protocol for long-term allograft surveillance in renal transplant recipients. (Preprint)

2020 ◽  
Author(s):  
Bethany Dale ◽  
Subhassih Bose ◽  
Sheng Kuo ◽  
Alana Burns ◽  
Pierre Daou ◽  
...  
Keyword(s):  
Kidney Transplantation ◽  
Immune System ◽  
Renal Transplant ◽  
Kidney Transplant ◽  
Kidney Function ◽  
Renal Transplant Recipients ◽  
Transplant Recipients ◽  
Allograft Survival ◽  
Post Transplant

BACKGROUND End Stage Kidney Disease (ESKD) patients require complex and expensive medical management. Kidney transplantation remains the treatment of choice for ESKD and is considered superior to all other modalities of renal replacement therapy (RRT) or dialysis. However, access to kidney transplant is limited by critical supply-demand making it extremely important to ensure longevity of transplanted kidneys. This is prevented through life-long immunosuppression, with caution not to overly suppress the immune system, resulting in toxicity and harm. Transition of care to community nephrologists after initial kidney transplantation and monitoring at a transplant center is an important process to ensure delivery of effective and patient-centric care closer to home. Once transplanted, laborious surveillance of the immune system and monitoring for potential rejection and injury is undertaken through an armamentarium of screening modalities. Post-transplant surveillance for kidney function and injury remained key to follow up care. While kidney function, quantified by estimated glomerular filtration rate (eGFR) and serum creatinine (SCr), and kidney injury, measured by proteinuria and hematuria, are standard biomarkers used to monitor injury and rejection post-transplant, they have recently been demonstrated to be inferior in performance to that of AlloSure® (CareDx, Inc. Brisbane, CA), circulating donor-derived cell-free DNA (dd-cfDNA). OBJECTIVE The outcomes and methods of monitoring renal transplant recipients (RTR) post-transplant have remained stagnant over the past 15 years. The aim of this study is to consider intensive surveillance using AlloSure® dd-cfDNA in an actively managed protocol assessing whether it increases long-term allograft survival in kidney transplant recipients compared with current standard clinical care in community nephrology. METHODS The study protocol will acquire data from a phase IV observational trial to assess a cohort of 2500 RTR patients managed using AlloSure® dd-cfDNA and patient care managers versus 1000 propensity matched historic controls using UNOS SRTR data. Data will be managed in a centralized electronic data server. RESULTS The primary outcome will be superior allograft survival, as a composite of return to dialysis, re-transplant, death due to allograft failure and death with a functional graft DWFG (infection, malignancy, and cardiovascular death). The secondary endpoints will assess improved kidney function through decline in eGFR and immune activity through development of donor specific antibody (DSA). CONCLUSIONS Based on a significant literature base, we believe implementing the surveillance of dd-cfDNA in the kidney transplant population will have a positive impact on graft survival. Through early identification of rejection and facilitating timely intervention, prolongation of allograft survival versus those not managed by dd-cfDNA surveillance protocol should be superior.

scholarly journals Current Pharmacological Intervention and Medical Management for Diabetic Kidney Transplant Recipients

Pharmaceutics ◽  
2021 ◽  
Vol 13 (3) ◽  
pp. 413
Author(s):  
Theerawut Klangjareonchai ◽  
Natsuki Eguchi ◽  
Ekamol Tantisattamo ◽  
Antoney J. Ferrey ◽  
Uttam Reddy ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Kidney Transplantation ◽  
Kidney Transplant ◽  
Pharmacological Intervention ◽  
Diabetic Patients ◽  
Transplant Recipients ◽  
Kidney Transplant Recipients ◽  
Kidney Allograft ◽  
Post Transplant ◽  
Glucose Management

Hyperglycemia after kidney transplantation is common in both diabetic and non-diabetic patients. Both pretransplant and post-transplant diabetes mellitus are associated with increased kidney allograft failure and mortality. Glucose management may be challenging for kidney transplant recipients. The pathophysiology and pattern of hyperglycemia in patients following kidney transplantation is different from those with type 2 diabetes mellitus. In patients with pre-existing and post-transplant diabetes mellitus, there is limited data on the management of hyperglycemia after kidney transplantation. The following article discusses the nomenclature and diagnosis of pre- and post-transplant diabetes mellitus, the impact of transplant-related hyperglycemia on patient and kidney allograft outcomes, risk factors and potential pathogenic mechanisms of hyperglycemia after kidney transplantation, glucose management before and after transplantation, and modalities for prevention of post-transplant diabetes mellitus.

scholarly journals Providers’ View on the First Kidney Transplantation Center in Ethiopia: Experience From Past to Present

2021 ◽  
Vol 8 ◽  
pp. 233339282110183
Author(s):  
Tariku Shimels ◽  
Abrham Getachew ◽  
Mekdim Tadesse ◽  
Alison Thompson
Keyword(s):  
Kidney Transplantation ◽  
Renal Transplant ◽  
Health Care Providers ◽  
Study Data ◽  
Care Providers ◽  
Transplant Center ◽  
Transplantation Center ◽  
Stage Renal Disease ◽  
End Stage

Introduction: Transplantation is the optimal management for patients with end-stage renal disease. In Ethiopia, the first national kidney transplantation center was opened at St. Paul’s Hospital Millennium Medical College in September 2015. The aim of this study was to explore providers’ views and experiences of the past to present at this center. Methods: A qualitative study design was employed from 1st November to 15th December, 2019. To ensure that appropriate informants would provide rich study data, 8 health care providers and top management members were purposefully chosen for in-depth interviews. A maximum variation sampling method was considered to include a representative sample of informants. Interviews were digitally audio-recorded, and transcribed verbatim. Transcribed data was coded and analyzed using Qualitative Data Analysis (QDA) Minor Lite software and Microsoft-Excel. Result: The participants (5 males and 3 females) approached were from different departments of the renal transplant center, and the main hospital. Eight main themes and 18 sub-themes were generated initially from all interviews totaling to 109 index codes. Further evaluation and recoding retained 5 main themes, and 14 sub-themes. The main themes are; challenges experienced during and after launching the center, commitment, sympathy and satisfaction, outcomes of renal transplant, actions to improve the quality of service, and how the transplant center should operate. Providers claim that they discharge their responsibilities through proper commitment and compassion, paying no attention to incentive packages. They also explained that renal transplantation would have all the outcomes related to economic, humanistic and clinical facets. Conclusion and Recommendation: A multitude of challenges were faced during and after the establishment of the first renal transplant center in Ethiopia. Providers discharge their responsibility through a proper compassion for patients. Concerned stakeholders should actively collaborate to improve the quality of renal transplant services in the center.

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 A Kidney Transplant Recipient with Recurrent Henoch-Schönlein Purpura Nephritis Successfully Treated with Steroid Pulse Therapy and Epipharyngeal Abrasive Therapy

Nephron ◽  
2020 ◽  
pp. 1-5
Author(s):  
Mika Fujimoto ◽  
Kan Katayama ◽  
Kouhei Nishikawa ◽  
Shoko Mizoguchi ◽  
Keiko Oda ◽  
...  
Keyword(s):  
Renal Function ◽  
Kidney Transplantation ◽  
Transplant Recipient ◽  
Kidney Transplant ◽  
Kidney Transplant Recipient ◽  
Pulse Therapy ◽  
Steroid Pulse Therapy ◽  
Steroid Pulse ◽  
Schonlein Purpura ◽  
Purpura Nephritis

There is no specific treatment for recurrent Henoch-Schönlein purpura nephritis (HSPN) in a transplanted kidney. We herein report a case of a kidney transplant recipient with recurrent HSPN that was successfully treated with steroid pulse therapy and epipharyngeal abrasive therapy (EAT). A 39-year-old Japanese man developed HSPN 4 years ago and had to start hemodialysis after 2 months despite receiving steroid pulse therapy followed by oral prednisolone, plasma exchange therapy, and cyclophosphamide pulse therapy. He had undergone tonsillectomy 3 years earlier in the hopes of achieving a better outcome of a planned kidney transplantation and received a living-donor kidney transplantation from his mother 1 year earlier. Although there were no abnormalities in the renal function or urinalysis 2 months after transplantation, a routine kidney allograft biopsy revealed evidence of mesangial proliferation and cellular crescent formation. Mesangial deposition for IgA and C3 was noted, and he was diagnosed with recurrent HSPN histologically. Since the renal function and urinalysis findings deteriorated 5 months after transplantation, 2 courses of steroid pulse therapy were performed but were ineffective. EAT using 0.5% zinc chloride solution once per day was combined with the third course of steroid pulse therapy, as there were signs of chronic epipharyngitis. His renal function recovered 3 months after daily EAT and has been stable for 1.5 years since transplantation. Daily EAT continued for &#x3e;3 months might be a suitable strategy for treating recurrent HSPN in cases of kidney transplantation.

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