scholarly journals Ureteric Trauma following Stent Removal in Kidney Transplant Recipient: A Unique Case of Prolonged Morbidity

2021 ◽  
Vol 2021 ◽  
pp. 1-4
Author(s):  
Ahmad Mirza ◽  
Imran Gani ◽  
Andy Shi Huang ◽  
Ravi Mallavarapu ◽  
Laura Mulloy ◽  
...  
Keyword(s):  
Kidney Transplant ◽  
Kidney Transplant Recipient ◽  
Deceased Donor ◽  
Filling Defect ◽  
Percutaneous Nephrostomy ◽  
Distal Ureter ◽  
Noncontrast Ct ◽  
Deceased Donor Kidney Transplant ◽  
Stage Renal Disease ◽  
End Stage

A 52-year-old African-American male patient with end-stage renal disease due to hypertension underwent deceased donor kidney transplant procedure with no immediate complications. The postprocedure complications, interventions, and course were abstracted by chart review. The ureteric stent was removed with flexible cystoscopy on postoperative day (POD) 24. 24 hours later, the patient presented with abdominal pain and inability to urinate. An urgent ultrasound and noncontrast CT scan showed grade 4 hydronephrosis of the transplanted kidney. A percutaneous nephrostomy stent was placed for urinary diversion. A large ureteric hematoma filling the lumen of the mid to distal ureter was identified on the nephrostogram and was evacuated. A follow-up nephrostogram on POD 44 revealed a distal ureter stricture and persistent well-formed midureter filling defect. A repeat nephrostogram performed at POD 72 was done with stricture dilatation, internalization of stents, and removal of a percutaneous nephrostomy tube. The patient was maintained on antibiotics for UTI prophylaxis throughout the course.

scholarly journals Short Bowel Syndrome and Kidney Transplantation: Challenges, Outcomes, and the Use of Teduglutide

2020 ◽  
Vol 2020 ◽  
pp. 1-5
Author(s):  
Elizabeth Abou Diwan ◽  
Ankit B. Patel ◽  
Alex G. Cuenca ◽  
Nahel Elias ◽  
Hannah M. Gilligan ◽  
...  
Keyword(s):  
Kidney Transplantation ◽  
Kidney Transplant ◽  
Short Bowel Syndrome ◽  
Kidney Transplant Recipient ◽  
Deceased Donor ◽  
Volume Depletion ◽  
Short Bowel ◽  
Deceased Donor Kidney ◽  
Deceased Donor Kidney Transplant ◽  
First Time

Among patients with short bowel syndrome who commonly have kidney disease, kidney transplantation remains challenging. We describe the clinicopathologic course of a 59-year old man with short bowel syndrome secondary to Crohn’s disease who underwent a deceased donor kidney transplant that was complicated by recurrent acute kidney allograft injury due to volume depletion from diarrhea, ultimately requiring the placement of permanent intravenous access for daily volume expansion at home resulting in the recovery of allograft function. Teduglutide treatment at 1.8 years post-transplant led to a dramatic decrease in diarrhea. A literature review of similar cases yielded 18 patients who underwent 19 kidney transplants. Despite high rates of complications, at the time of last follow-up (median 2.1 years [0.04-7]), 94% of the patients were still alive and 89% had functioning allografts, with a median eGFR of 37.5 [14-122] ml/min/1.73m2. In conclusion, despite high rates of complications, kidney transplantation in patients with short bowel syndrome is associated with acceptable short- and midterm outcomes. Further, we report for the first time the effects of the glucagon-like peptide-2 analogue teduglutide for short bowel syndrome in a kidney transplant recipient.

scholarly journals A Case of Alport Syndrome with Posttransplant Antiglomerular Basement Membrane Disease despite Negative Antiglomerular Basement Membrane Antibodies by EIA Treated with Plasmapheresis and Intravenous Immunoglobulin

2013 ◽  
Vol 2013 ◽  
pp. 1-5
Author(s):  
Sumiko I. Armstead ◽  
Thomas Hellmark ◽  
Jorgen Wieslander ◽  
Xin J. Zhou ◽  
Ramesh Saxena ◽  
...  
Keyword(s):  
Basement Membrane ◽  
Intravenous Immunoglobulin ◽  
Alport Syndrome ◽  
Kidney Injury ◽  
Deceased Donor ◽  
End Of Treatment ◽  
Circulating Antibodies ◽  
Deceased Donor Kidney Transplant ◽  
Stage Renal Disease ◽  
End Stage

Posttransplant antiglomerular basement membrane (anti-GBM) disease occurs in approximately 5% of Alport patients and usually ends in irreversible graft failure. Recent research has focused on characterizing the structure of the anti-GBM alloepitope. Here we present a case of a 22-year-old male with end-stage renal disease secondary to Alport syndrome, with a previously failed renal allograft, who received a second deceased-donor kidney transplant. Six days after transplantation, he developed acute kidney injury. The serum anti-GBM IgG was negative by enzyme immunoassay (EIA). On biopsy, he had crescentic glomerulonephritis with linear GBM fixation of IgG. With further analysis by western blotting, we were able to detect antibodies to an unidentified protein from the basement membrane. This patient was treated with plasmapheresis twice per week and monthly intravenous immunoglobulin (IVIG) for a total of five months. At the end of treatment, these unknown antibodies were no longer detected. His renal function improved, and he has not required dialysis. We conclude that anti-GBM disease in patients with Alport Syndrome may be caused by circulating antibodies to other components of the basement membrane that are undetectable by routine anti-GBM EIA and may respond to treatment with plasmapheresis and IVIG.

scholarly journals Surgical approach for kidney transplantation under spinal anesthesia

2020 ◽  
Vol 2020 (12) ◽  
Author(s):  
Atta Nawabi ◽  
Peter Sullivan ◽  
Martin De Ruyter ◽  
Amy Pichoff ◽  
Clay D King ◽  
...  
Keyword(s):  
Kidney Transplantation ◽  
Spinal Anesthesia ◽  
Deceased Donor ◽  
Annual Data ◽  
Short Supply ◽  
Deceased Donor Kidney ◽  
Airway Equipment ◽  
Deceased Donor Kidney Transplant ◽  
Stage Renal Disease ◽  
End Stage

Abstract Kidney transplantation is the treatment of choice for patients with end-stage renal disease (ESRD). It has been shown to improve quality of life as well as extending life of patients with ESRD as compared to renal replacement therapy (5-year survival rate of 68% after transplant vs 36% dialysis) (Hart A, Smith JM, Skeans MA. OPTN/SRTR 2015 annual data report: kidney. Am J Transplant 2017;17:21–116). Traditionally, patients undergo general endotracheal tube anesthesia for this surgery. During the COVID-19 pandemic, general anesthesia drugs and airway equipment were in short supply. Additionally, airway manipulation was avoided when possible due to concern for virus spread from aerosolizing procedures (i.e. intubation/extubation). In this case report, we review a 65-year-old female with an ESRD due to hypertension and diabetes that underwent deceased donor kidney transplant under spinal anesthesia. We will further discuss the benefits of spinal anesthesia in renal transplant operations.

scholarly journals Élő donoros vesetranszplantációt követő terhességben kialakult terápiarezisztens hypertonia

2021 ◽  
Vol 162 (23) ◽  
pp. 924-926
Author(s):  
Bernadett Borda ◽  
Csilla Keresztes ◽  
Attila Keresztúri
Keyword(s):  
Kidney Transplant ◽  
Kidney Transplant Recipient ◽  
Calcineurin Inhibitors ◽  
Clinic Visit ◽  
Maternal Complications ◽  
Maintenance Immunosuppression ◽  
Allograft Function ◽  
Medication Risk ◽  
Stage Renal Disease ◽  
End Stage

Összefoglaló. A veseátültetés a legnagyobb reményt nyújtja a végstádiumú vesebetegségben szenvedő nők számára, akik teherbe kívánnak esni. A veseátültetett beteg terhessége továbbra is kihívást jelent az immunszuppresszív gyógyszerek mellékhatásai, az allograftfunkció romlásának kockázata, a praeeclampsia és a magas vérnyomás káros anyai szövődményeinek rizikója, valamint a koraszülés, az alacsony születési súly kockázata miatt. A terhesség alatt nagy a magas vérnyomás kialakulásának kockázata, a szérum-kretaininszint emelkedik, és a terhesség végére proteinuria is kialakulhat. Az ajánlott fenntartó immunszuppresszió terhes nőknél a kalcineurininhibitorok (takrolimusz/ciklosporin) és alacsony dózisú szteroid adása, melyek biztonságosnak tekinthetők. Fontos, hogy a gyermekvállalási tanácsadás már a vesetranszplantáció előtt megkezdődjön, és a transzplantációt követően minden klinikai kontroll megtörténjen. Orv Hetil. 2021; 162(23): 924–926. Summary. Kidney transplantation offers the best hope to women with end-stage renal disease who wish to become pregnant. Pregnancy in a kidney transplant recipient continues to remain challenging due to side effects of immunosuppressive medication, risk of deterioration of allograft function, risk of adverse maternal complications of preeclampsia and hypertension, and risk of adverse fetal outcomes of premature birth, low birth weight, and small for gestational age infants. The factors associated with poor pregnancy outcomes include the presence of hypertension, serum creatinine greater than normal range and proteinuria. The recommended maintenance immunosuppression in pregnant women is calcineurin inhibitors (tacrolimus/cyclosporine) and low-dose steroid which are considered safe. It is important that counseling for childbearing should start as early as prior to getting a kidney transplant and should be done at every clinic visit after transplant. Orv Hetil. 2021; 162(23): 924–926.

scholarly journals Successful Transplantation of a Split Crossed Fused Ectopic Kidney into a Patient with End-Stage Renal Disease

2010 ◽  
Vol 2010 ◽  
pp. 1-5 ◽  
Author(s):  
Kristin L. Mekeel ◽  
Shane M. Daley ◽  
Paul E. Andrews ◽  
Adyr A. Moss ◽  
R. L. Heilman ◽  
...  
Keyword(s):  
Deceased Donor ◽  
Technical Difficulty ◽  
Parenchymal Transection ◽  
Ectopic Kidney ◽  
Renal Anomalies ◽  
Successful Transplantation ◽  
Immediate Function ◽  
Deceased Donor Kidney Transplant ◽  
Stage Renal Disease ◽  
End Stage

Potential donors with congenital renal anomalies but normal renal function are often overlooked because of a possible increase in technical difficulty and complications associated with the surgery. However, as the waiting list for a deceased donor kidney transplant continues to grow, it is important to consider these kidneys for potential transplant. This paper describes the procurement of a crossed fused ectopic kidney, and subsequent parenchymal transection prior to transplantation as part of a combined simultaneous kidney pancreas transplant. The transplant was uncomplicated, and the graft had immediate function. The patient is now two years from transplant with excellent function.

scholarly journals Economic Considerations in Using HCV and HIV Positive Donors for Kidney Transplant

2021 ◽  
Vol 05 (04) ◽  
pp. 1-1
Author(s):  
Aniruddha Bhattacharyya ◽  
◽  
Lee R. Friedman ◽  
Beje S. Thomas ◽  
Coleman I. Smith ◽  
...  
Keyword(s):  
Kidney Transplant ◽  
Hiv Infections ◽  
Deceased Donor ◽  
The United States ◽  
Opioid Use ◽  
Donor Pool ◽  
Socioeconomic Impacts ◽  
Novel Method ◽  
Stage Renal Disease ◽  
End Stage

End Stage Renal Disease is becoming more prevalent in the United States of America, with demand for kidney transplant exceeding the available organ supply. A novel method to increase the donor pool has been to consider transplanting organs from deceased patients who have had Hepatitis C Virus (HCV) or Human Immunodeficiency Virus (HIV) infections. Transplants with HCV infected kidneys are becoming more prevalent, due to increased organ supply due to increased mortality from injection opioid use. Similarly, deceased donor transplants using kidneys infected with HIV have become more common following the passage of the “HIV Organ Policy Equity (HOPE) Act” in 2013. These novel transplant strategies present distinct socioeconomic impacts which differ from those of prior transplant practices. Here, we have reviewed the costs and benefits of receiving a kidney transplant from deceased donors infected with HIV or HCV, compared to receiving a non-viremic kidney transplant.

Urolithiasis in a Deceased Donor Kidney Transplant Recipient: Case Report

2021 ◽  
Vol 19 (12) ◽  
pp. 1341-1344
Author(s):  
Fouad Shearya ◽  
Muneira Algethamy ◽  
Samar Ahmed ◽  
Walla Algehany ◽  
Manar Alshahrani ◽  
...  
Keyword(s):  
Case Report ◽  
Transplant Recipient ◽  
Kidney Transplant ◽  
Kidney Transplant Recipient ◽  
Deceased Donor ◽  
Donor Kidney ◽  
Deceased Donor Kidney ◽  
Deceased Donor Kidney Transplant

scholarly journals Study of prevalence of lymphoceles after kidney transplantation

2021 ◽  
Vol 6 (2) ◽  
pp. e28-e28
Author(s):  
Afshar Zomorodi ◽  
Farnood Salmani Milani ◽  
Mohsen Mohammad Rahimi
Keyword(s):  
Kidney Transplantation ◽  
Kidney Transplant ◽  
Deceased Donor ◽  
Target Population ◽  
Transplant Recipients ◽  
Cross Sectional ◽  
Transplant Center ◽  
Male Patients ◽  
Stage Renal Disease ◽  
End Stage

Introduction: One of the complications of renal transplantation after surgery, which is frequently observed, is the symptomatic accumulation of fluid around the kidney, such as hematoma, lymphocele or lymphuria. Objectives: The incidence of lymphocele after kidney transplantation is widely different, therefore we decided to conduct a study to investigate the prevalence of lymphocytes in transplant recipients. Patients and Methods: The present study was a cross-sectional descriptive-analytical study. The target population in this study was adult and middle-aged men and women with end-stage renal disease (ESRD) who have undergone kidney transplant surgery at the kidney center of Imam Reza hospital in the last 5 years. Results: In all transplant recipients, symptomatic lymphoceles were observed in only 5 patients (3 female and 2 male patients with the mean age of 40.2±17.2 years) who occurred on average 48.4 ± 21.12 days after surgery between 24 days and 78 days. The results showed that 62% (156 cases) of patients were men and 211 patients (84.4%) were male transplant recipients. Also, 198 (79.2%) transplant donors were living donor and 52 (20.8%) were deceased donor/brain death. Conclusion: In the present study, we found the prevalence of lymphocele in transplant recipients in the kidney transplant center of Imam Reza in five years is 5 patients (2%) out of 250 patients with an average annual incidence of 1-2%.

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