scholarly journals Assessing Kidney Graft Viability and Its Cells Metabolism during Machine Perfusion

2021 ◽  
Vol 22 (3) ◽  
pp. 1121 ◽  
Author(s):  
Maria Irene Bellini ◽  
Francesco Tortorici ◽  
Maria Ida Amabile ◽  
Vito D’Andrea
Keyword(s):  
Graft Function ◽  
Kidney Graft ◽  
Machine Perfusion ◽  
Donation After Circulatory Death ◽  
Viability Assessment ◽  
Organ Quality ◽  
Dynamic Techniques ◽  
Stage Renal Disease ◽  
End Stage ◽  
Circulatory Death

Kidney transplantation is the golden treatment for end-stage renal disease. Static cold storage is currently considered the standard method of preservation, but dynamic techniques, such as machine perfusion (MP), have been shown to improve graft function, especially in kidneys donated by extended criteria donors and donation after circulatory death. With poor organ quality being a major reason for kidneys not being transplanted, an accurate, objective and reliable quality assessment during preservation could add value and support to clinicians’ decisions. MPs are emerging technologies with the potential to assess kidney graft viability and quality, both in the hypothermic and normothermic scenarios. The aim of this review is to summarize current tools for graft viability assessment using MP prior to implantation in relation to the ischemic damage.

Identification of Impeding Factors for Dry Weight Achievement in End-Stage Renal Disease After Appropriate Kidney Graft Function

2013 ◽  
Vol 38 (2) ◽  
pp. 113-120 ◽  
Author(s):  
Sonia Catalina Rivera-González ◽  
Héctor Pérez-Grovas ◽  
Magdalena Madero ◽  
Franklin Mora-Bravo ◽  
Nadia Saavedra ◽  
...  
Keyword(s):  
Renal Disease ◽  
End Stage Renal Disease ◽  
Graft Function ◽  
Dry Weight ◽  
Kidney Graft ◽  
Stage Renal Disease ◽  
End Stage

scholarly journals Cardiac Graft Assessment in the Era of Machine Perfusion: Current and Future Biomarkers

2021 ◽  
Vol 10 (4) ◽  
Author(s):  
Martina Bona ◽  
Rahel K. Wyss ◽  
Maria Arnold ◽  
Natalia Méndez‐Carmona ◽  
Maria N. Sanz ◽  
...  
Keyword(s):  
Current Knowledge ◽  
Cellular Damage ◽  
Ex Situ ◽  
Machine Perfusion ◽  
Clinical Protocols ◽  
Donation After Circulatory Death ◽  
Graft Storage ◽  
End Stage ◽  
Circulatory Death ◽  
Cardiac Graft

Abstract Heart transplantation remains the treatment of reference for patients experiencing end‐stage heart failure; unfortunately, graft availability through conventional donation after brain death is insufficient to meet the demand. Use of extended‐criteria donors or donation after circulatory death has emerged to increase organ availability; however, clinical protocols require optimization to limit or prevent damage in hearts possessing greater susceptibility to injury than conventional grafts. The emergence of cardiac ex situ machine perfusion not only facilitates the use of extended‐criteria donor and donation after circulatory death hearts through the avoidance of potentially damaging ischemia during graft storage and transport, it also opens the door to multiple opportunities for more sensitive monitoring of graft quality. With this review, we aim to bring together the current knowledge of biomarkers that hold particular promise for cardiac graft evaluation to improve precision and reliability in the identification of hearts for transplantation, thereby facilitating the safe increase in graft availability. Information about the utility of potential biomarkers was categorized into 5 themes: (1) functional, (2) metabolic, (3) hormone/prohormone, (4) cellular damage/death, and (5) inflammatory markers. Several promising biomarkers are identified, and recommendations for potential improvements to current clinical protocols are provided.

scholarly journals Outcomes in Living Donor Kidney Transplantation: The Role of Donor’s Kidney Function

2021 ◽  
pp. 1-11
Author(s):  
Massimo Torreggiani ◽  
Ciro Esposito ◽  
Elena Martinelli ◽  
Thomas Jouve ◽  
Antoine Chatrenet ◽  
...  
Keyword(s):  
Kidney Transplant ◽  
Kidney Function ◽  
Living Donor ◽  
Graft Function ◽  
Kidney Graft ◽  
Donor Kidney ◽  
Transplant Center ◽  
Function Correlation ◽  
End Stage ◽  
Living Donor Kidney

<b><i>Introduction:</i></b> Living donor kidney transplant (LDKT) is one of the best therapeutic options for end-stage kidney disease (ESKD). Guidelines identify different estimated glomerular filtration rate (eGFR) thresholds to determine the eligibility of donors. The aim of our study was to evaluate whether pretransplant donor eGFR was associated with kidney function in the recipient. <b><i>Methods:</i></b> We retrospectively studied LDKT recipients who received a kidney graft between September 1, 2005, and June 30, 2016 in the same transplant center in France and that had eGFR data available at 3, 12, 24, and 36 months posttransplant. <b><i>Results:</i></b> We studied 90 donor-recipient pairs. The average age at time of transplant was 51.47 ± 10.95 for donors and 43.04 ± 13.52 years for recipients. Donors’ average eGFR was 91.99 ± 15.37 mL/min/1.73 m<sup>2</sup>. Donor’s age and eGFR were significantly correlated (<i>p</i> &#x3c; 0.0001, <i>r</i><sup>2</sup> 0.023). Donor’s age and eGFR significantly correlated with recipient’s eGFR at 3, 12, and 24 months posttransplant (age: <i>p</i> &#x3c; 0.001 at all intervals; eGFR <i>p</i> = 0.001, 0.003, and 0.016, respectively); at 36 months, only donor’s age significantly correlated with recipient’s eGFR. BMI, gender match, and year of kidney transplant did not correlate with graft function. In the multivariable analyses, donor’s eGFR and donor’s age were found to be associated with graft function; correlation with eGFR was lost at 36 months; and donor’s age retained a strong correlation with graft function at all intervals (<i>p</i> &#x3c; 0.001). <b><i>Conclusions:</i></b> Donor’s eGFR and age are strong predictors of recipient’s kidney function at 3 years. We suggest that donor’s eGFR should be clinically balanced with other determinants of kidney function and in particular with age.

scholarly journals Laparoscopic-Assisted Recipient Nephrectomy and Recipient Kidney Procurement during Orthotopic Living-Related Kidney Transplantation

2011 ◽  
Vol 2011 ◽  
pp. 1-4 ◽  
Author(s):  
Dimitri Mikhalski ◽  
Karl Martin Wissing ◽  
Renaud Bollens ◽  
Daniel Abramowicz ◽  
Vincent Donckier ◽  
...  
Keyword(s):  
Kidney Transplantation ◽  
Antiphospholipid Antibodies ◽  
Graft Function ◽  
Renal Vessels ◽  
Short Period ◽  
History Of ◽  
Stage Renal Disease ◽  
End Stage ◽  
Living Related ◽  
Laparoscopic Assisted

Advanced atherosclerosis or thrombosis of iliac vessels can constitute an absolute contraindication for heterotopic kidney transplantation. We report the case of a 42-year-old women with end-stage renal disease due to lupus nephritis and a history of bilateral thrombosis of iliac arteries caused by antiphospholipid antibodies. Occlusion had been treated by the bilateral placement of wall stents which precluded vascular anastomosis. The patient was transplanted with a right kidney procured by laparoscopic nephrectomy from her HLA semi-identical sister. The recipient had left nephrectomy after laparoscopical transperitoneal dissection. The donor kidney was orthotopically transplanted with end-to-end anastomosis of graft vessels to native renal vessels and of the graft and native ureter. Although, the patient received full anticoagulation because of a cardiac valve and antiphospholipid antibodies, she had no postoperative complication in spite of a short period of delayed graft function. Serum creatinine levels three months after transplantation were at 1.0 mg/dl. Our case documents that orthotopical transplantation of laparoscopically procured living donor kidneys at the site of recipient nephrectomy is a feasible procedure in patients with surgical contraindication of standard heterotopic kidney transplantation.

scholarly journals TO004IMPACT OF RENAL TRANSPLANT ON COGNITIVE FUNCTION AMONG ESRD PATIENTS ON DIALYSIS

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Anupma Kaul ◽  
Dharmendra Bhaduria ◽  
Narayan Prasad ◽  
Amit Gupta
Keyword(s):  
Cognitive Function ◽  
Kinetic Modelling ◽  
Memory Performance ◽  
Graft Function ◽  
Post Transplant ◽  
Formal Kinetic ◽  
Psychomotor Ability ◽  
Normative Comparisons ◽  
Stage Renal Disease ◽  
End Stage

Abstract Background and Aims Kidney transplantation can help in mitigating neuropsychological (NP) impairments in end-stage renal disease (ESRD). Evidences have shown mixed responses on the the nature of cognitive function in patients who have undergone renal transplantation.Present study looked into the factors impacting cognitive domains and impact post transplant. Method 43 patients who were stable ESRD on thrice a week hemodialysis were investigated 6 months pre and post transplant using a battery of neurophysiological testing assessing attention–concentration, psychomotor ability and memory. Formal kinetic modelling of dialysis delivery ensured adequate renal replacement therapy. Transplant function was assessed on regular interval and following a stable graft function and on stable doses of immunosuppressive medication 6 months post transplant were reassessed Results Within-subject comparisons showed statistically significant improvement in memory performance after kidney transplant. Other NP measures (attention– concentration and psychomotor abilities) showed non-significant improvements. Normative comparisons showed NP impairments on dialysis, which were not apparent after transplant Conclusion These data demonstrate improvements in cognition following kidney TX and emphasize the reversibility of the memory problems evidenced in dialysis

Blood Glucose and Cholesterol Control Improved by Continuous Ambulatory Peritoneal Dialysis in Patients with End-Stage Renal Disease and Diabetes Mellitus

1993 ◽  
Vol 13 (2_suppl) ◽  
pp. 239-241 ◽  
Author(s):  
Ann-Marie Wikdahl ◽  
Lena Granbom ◽  
Jens G. Sörensen ◽  
Bernd G. Stegmayr
Keyword(s):  
Peritoneal Dialysis ◽  
Serum Albumin ◽  
Total Cholesterol ◽  
End Stage Renal Disease ◽  
Kidney Graft ◽  
Group 2 ◽  
Cholesterol Control ◽  
Stage Renal Disease ◽  
End Stage ◽  
Group 1

This longitudinal study was performed to evaluate the change of total cholestererol, triglycerides, and glucose control in patients with insulin-dependent diabetes mellitus (IDDM) and end-stage renal disease (ESRD) during predialysis (PreD), on continuous ambulatory peritoneal dialysis (CAPD) and after kidney graft. A total of 20 consecutive patients (7 women, 13 men, mean age 42 years) with IDDM and ESRD were studied retrospectively in 1991 during PreD and during CAPD. Twelve were also investigated after obtaining a kidney graft. Insulin was administered Intraperitoneally (CAPD period) and subcutaneously (PreD and transplant). The mean values of weight, serum albumin, glycosylated hemoglobin (HbA1c), total cholesterol, and triglycerldes were calculated during each period. Patients were age and sex-matched with a group of healthy controls (Group 1) and with a group of patients with IDDM without nephropathy (Group 2). T-test statistics were used. During CAPD, there were significant decreases in HbA1c (mean 8.1 mmol/L vs 12.1, p=0.003) and cholesterol (mean 6.1 mmol/L vs 7.1, p=0.025) compared to PreD. No differences were found between PreD and CAPD stages with regard to weight, serum albumin, or triglycerides. After transplantation an improvement was found In serum albumin compared to PreD and CAPD (mean value 40 g/L.vsvs 34 and 35, p<0.03), and HbA1c compared to PreD (9.6 mmol/L vs 12.1, p=0.014), if the pancreas transplanted were included. Patients compared to Group 1 or 2 showed no differences in total cholesterol or triglycerldes. HbA1c was higher in patients during PreD than in Group 2. Peritoneal dialysis may not be a poor alternative for glucose and total cholesterol control in diabetic patients with ESRD. Transplantation further Improves serum albumin.

scholarly journals Effects of Oxygen During Long-term Hypothermic Machine Perfusion in a Porcine Model of Kidney Donation After Circulatory Death

2019 ◽  
Vol 103 (10) ◽  
pp. 2057-2064 ◽  
Author(s):  
Leonie H. Venema ◽  
Aukje Brat ◽  
Cyril Moers ◽  
Nils A. ‘t Hart ◽  
Rutger J. Ploeg ◽  
...  
Keyword(s):  
Porcine Model ◽  
Kidney Donation ◽  
Machine Perfusion ◽  
Donation After Circulatory Death ◽  
Hypothermic Machine Perfusion ◽  
Circulatory Death
Sign in / Sign up

Export Citation Format

Share Document