scholarly journals Incentivized Kidney Exchange

2020 ◽  
Vol 110 (7) ◽  
pp. 2198-2224 ◽  
Author(s):  
Tayfun Sönmez ◽  
M. Utku Ünver ◽  
M. Bumin Yenmez
Keyword(s):  
Renal Failure ◽  
Continuum Model ◽  
Living Donor ◽  
Deceased Donor ◽  
Kidney Exchange ◽  
Welfare Benefits

Over the last 15 years, kidney exchange has become a mainstream paradigm to increase transplants. However, compatible pairs do not participate, and full benefits from exchange can be realized only if they do. We propose incentivizing compatible pairs to participate in exchange by insuring their patients against future renal failure via increased priority in deceased-donor queue. We analyze equity and welfare benefits of this scheme through a new dynamic continuum model. We calibrate the model with US data and quantify substantial gains from adopting incentivized exchange, both in terms of access to living-donor transplants and reduced competition for deceased-donor transplants. (JEL D47, I11, I12, I18)

scholarly journals Prediction model for early graft failure after liver transplantation using aspartate aminotransferase, total bilirubin and coagulation factor

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Jinsoo Rhu ◽  
Jong Man Kim ◽  
Kyunga Kim ◽  
Heejin Yoo ◽  
Gyu-Seong Choi ◽  
...  
Keyword(s):  
Liver Transplantation ◽  
Prediction Model ◽  
Aspartate Aminotransferase ◽  
Graft Failure ◽  
Living Donor ◽  
Total Bilirubin ◽  
Deceased Donor ◽  
Time Dependent ◽  
Early Graft ◽  
Early Graft Failure

AbstractThis study was designed to build models predicting early graft failure after liver transplantation. Cox regression model for predicting early graft failure after liver transplantation using post-transplantation aspartate aminotransferase, total bilirubin, and international normalized ratio of prothrombin time was constructed based on data from both living donor (n = 1153) and deceased donor (n = 359) liver transplantation performed during 2004 to 2018. The model was compared with Model for Early Allograft Function Scoring (MEAF) and early allograft dysfunction (EAD) with their C-index and time-dependent area-under-curve (AUC). The C-index of the model for living donor (0.73, CI = 0.67–0.79) was significantly higher compared to those of both MEAF (0.69, P = 0.03) and EAD (0.66, P = 0.001) while C-index for deceased donor (0.74, CI = 0.65–0.83) was only significantly higher compared to C-index of EAD. (0.66, P = 0.002) Time-dependent AUC at 2 weeks of living donor (0.96, CI = 0.91–1.00) and deceased donor (0.98, CI = 0.96–1.00) were significantly higher compared to those of EAD. (both 0.83, P < 0.001 for living donor and deceased donor) Time-dependent AUC at 4 weeks of living donor (0.93, CI = 0.86–0.99) was significantly higher compared to those of both MEAF (0.87, P = 0.02) and EAD. (0.84, P = 0.02) Time-dependent AUC at 4 weeks of deceased donor (0.94, CI = 0.89–1.00) was significantly higher compared to both MEAF (0.82, P = 0.02) and EAD. (0.81, P < 0.001). The prediction model for early graft failure after liver transplantation showed high predictability and validity with higher predictability compared to traditional models for both living donor and deceased donor liver transplantation.

A Case of Living-Donor Renal Transplantation for Chronic Renal Failure Caused by Secondary Amyloidosis

2011 ◽  
Vol 43 (6) ◽  
pp. 2418-2420 ◽  
Author(s):  
K. Sakai ◽  
M. Okamoto ◽  
K. Koshino ◽  
T. Suzuki ◽  
S. Nobori ◽  
...  
Keyword(s):  
Renal Failure ◽  
Renal Transplantation ◽  
Chronic Renal Failure ◽  
Living Donor ◽  
Secondary Amyloidosis

Renal transplantation in the first year of life: the treatment of choice for infants with end-stage renal disease.

1992 ◽  
Vol 2 (12) ◽  
pp. S228
Author(s):  
J S Najarian ◽  
P S Almond ◽  
M Mauer ◽  
B Chavers ◽  
T Nevins ◽  
...  
Keyword(s):  
Renal Failure ◽  
Renal Transplantation ◽  
Survival Rate ◽  
Living Donor ◽  
Patient Survival ◽  
First Year ◽  
End Stage Renal Failure ◽  
End Stage ◽  
First Year Of Life ◽  
Patient Survival Rate

The treatment of choice for end-stage renal failure within the first year of life is controversial. Between September 1970 and February 1991, we performed 28 kidney transplants (27 primary, 1 retransplant, 23 living donor, 5 cadaver) in infants less than 1 yr of age (mean, 7 +/- 2 months; range, 6 wk to 12 months). The 1-yr patient survival rate for living donor recipients was 100% versus 20% for cadaver recipients (P = 0.0001). The 1-yr graft survival rate for living donor recipients was 96% versus 20% for cadaver recipients (P = 0.001). The 1-yr patient survival rate for cyclosporin A (CSA) recipients (N = 12) was 100% versus 75% for non-CSA recipients (P = 0.03). The 1-yr graft survival rate for CSA recipients was 92% versus 75% for non-CSA recipients (P = 0.08). There was no difference in the number of rejection episodes or serum creatinine levels in CSA versus non-CSA recipients. Compared with pretransplant values, the mean posttransplant standard deviation scores (SDS) for height (N = 18), weight (N = 22), and head circumference (N = 8) improved: height SDS from -1.9 to -1.5 (not significant); weight SDS from -2.5 to 0.6 (P less than 0.0005); head circumference SDS from -2.0 to -0.7 (P = 0.01). Because no other renal replacement therapy can match these results, we conclude that renal transplantation is the treatment of choice for infants with end-stage renal failure.

scholarly journals De Novo Collapsing Glomerulopathy: An Unusual Cause of Early Graft Failure following Kidney Transplantation

2011 ◽  
Vol 2011 ◽  
pp. 1-3 ◽  
Author(s):  
Kalathil K. Sureshkumar ◽  
Imran Dosani ◽  
Katherine M. Jasnosz ◽  
Swati Arora
Keyword(s):  
Renal Failure ◽  
De Novo ◽  
Clinical Manifestations ◽  
Deceased Donor ◽  
Treatment Modalities ◽  
High Dose ◽  
Collapsing Glomerulopathy ◽  
Early Graft ◽  
Rapidly Progressive Renal Failure ◽  
Deceased Donor Kidney Transplant

Collapsing glomerulopathy (CG) is a variant of focal segmental glomerulosclerosis (FSGS) characterized histologically by prominent glomerular capillary tuft collapse with hypertrophy and hyperplasia of podocytes and tubulointerstitial damage. Patients usually present with heavy proteinuria and rapidly progressive renal failure. We report a patient who developed de novo CG with severe clinical manifestations including worsening renal failure and nephrotic syndrome within six months of receiving deceased donor kidney transplant. Secondary work-up was negative, and despite therapy with high-dose steroids and plasmapheresis, allograft function rapidly deteriorated with the need for dialysis. Theories about the pathogenesis of this entity as well as treatment modalities are discussed.

scholarly journals Aggravation of fibrin deposition and microthrombus formation within the graft during kidney transplantation

2021 ◽  
Author(s):  
Tamar A.J. van den Berg ◽  
Marius C. van den Heuvel ◽  
Janneke Wiersema-Buist ◽  
Jelle Adelmeijer ◽  
Gertrude J. Nieuwenhuijs-Moeke ◽  
...  
Keyword(s):  
Kidney Transplantation ◽  
Living Donor ◽  
Graft Function ◽  
Deceased Donor ◽  
Potential Difference ◽  
Fibrin Deposition ◽  
Peritubular Capillaries ◽  
Deposition Intensity

Abstract In kidney transplantation, microthrombi and fibrin deposition may lead to local perfusion disorders and subsequently poor initial graft function. Microthrombi are often regarded as donor-derived. However, the incidence, time of development, and potential difference between living donor kidneys (LDK) and deceased donor kidneys(DDK), remains unclear. Two open-needle biopsies, taken at preimplantation and after reperfusion, were obtained from 17 LDK and 28 DDK transplanted between 2005 and 2008. Paraffin-embedded sections were immunohistochemically stained with anti-fibrinogen antibody. Fibrin deposition intensity in peritubular capillaries(PTC) and glomeruli was categorized as negative, weak, moderate or strong and the number of microthrombi/mm2 was quantified. Reperfusion biopsies showed more fibrin deposition (20–100% moderate/strong, p < 0.001) and more microthrombi/mm2 (0.97 ± 1.12 vs. 0.28 ± 0.53, p < 0.01) than preimplantation biopsies. In addition, more microthrombi/mm2 (0.38 ± 0.61 vs. 0.09 ± 0.22, p = 0.02) and stronger fibrin intensity in glomeruli (28% vs. 0%, p < 0.01) and PTC (14% vs. 0%, p = 0.02) were observed in preimplantation DDK than LDK biopsies. After reperfusion, microthrombi/mm2 were comparable (p = 0.23) for LDK (0.09 ± 0.22 to 0.76 ± 0.49, p = 0.03) and DDK (0.38 ± 0.61 to 0.90 ± 1.11, p = 0.07). Upon reperfusion, there is an aggravation of microthrombus formation and fibrin deposition within the graft. The prominent increase of microthrombi in LDK indicates that they are not merely donor-derived.

scholarly journals Hospitalization Rates Before and After Adult-to-Adult Living Donor or Deceased Donor Liver Transplantation

2010 ◽  
Vol 251 (3) ◽  
pp. 542-549 ◽  
Author(s):  
Robert M. Merion ◽  
Tempie H. Shearon ◽  
Carl L. Berg ◽  
James E. Everhart ◽  
Michael M. Abecassis ◽  
...  
Keyword(s):  
Liver Transplantation ◽  
Living Donor ◽  
Deceased Donor ◽  
Donor Liver ◽  
Donor Liver Transplantation ◽  
Hospitalization Rates ◽  
Deceased Donor Liver Transplantation ◽  
Before And After

Revaluation and lessons learned from the first 9 cases of a Czech uterus transplantation trial: Four deceased donor and 5 living donor uterus transplantations

2018 ◽  
Vol 19 (3) ◽  
pp. 855-864 ◽  
Author(s):  
Roman Chmel ◽  
Marta Novackova ◽  
Libor Janousek ◽  
Jan Matecha ◽  
Zlatko Pastor ◽  
...  
Keyword(s):  
Living Donor ◽  
Deceased Donor ◽  
Lessons Learned ◽  
Uterus Transplantation
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