scholarly journals Enhanced Recovery after Renal Transplantation Decreases Recipients’ Urological Complications and Hospital Stay: A Systematic Review and Meta-Analysis

2021 ◽  
Vol 10 (11) ◽  
pp. 2286
Author(s):  
Apostolos Prionas ◽  
Charles Craddock ◽  
Vassilios Papalois
Keyword(s):  
Renal Transplant ◽  
Perioperative Care ◽  
Enhanced Recovery ◽  
Meta Analysis ◽  
Renal Transplant Recipients ◽  
Transplant Recipients ◽  
Readmission Rates ◽  
Post Transplant ◽  
Urological Complications ◽  
One Year

The objective of this study was to compare enhanced recovery after surgery (ERAS) against traditional perioperative care for renal transplant recipients. Outcome measures included complications, length of stay (LOS), readmission rates, graft and patient survival up to one-year post-transplant. We initially screened Medline, Cochrane, Scopus, Embase and Web of Science databases. We identified 3029 records. From these, 114 full texts were scrutinized for inclusion. Finally, 10 studies were included in the meta-analysis corresponding to 2037 renal transplant recipients. ERAS resulted in lower incidence of urological complications (95CI: 0.276, 0.855) (I2 = 53.08%) compared to traditional perioperative practice. This referred to ureteric stenoses (95CI: 0.186–0.868) (I2 = 0%) and urinary tract infections (95CI: 0.230–0.978) (I2 = 71.55%). ERAS decreased recipients’ LOS (95CI: −2.876, −0.835) (I2 = 86.55%). Compared to standard practice, ERAS protocols did not increase unplanned readmissions (95CI:0.800, 1.680) (I2 = 0%). Up to one-year post-transplant, graft survival rates were similar across the ERAS and the control groups (95CI:0.420, 1.722) (I2 = 0%). There was also no difference in recipients’ one-year post-transplant survival (95CI:0.162, 3.586) (I2 = 0%). Our results suggest that ERAS protocols can be safely incorporated in the perioperative care of renal transplant recipients, decrease their urological complications and shorten their length of hospital stay without affecting unplanned readmission rates.

scholarly journals Post-Transplant Diabetes Mellitus and Prediabetes in Renal Transplant Recipients: An Update

Nephron ◽  
2021 ◽  
pp. 1-13
Author(s):  
Ana Elena Rodríguez-Rodríguez ◽  
Esteban Porrini ◽  
Mads Hornum ◽  
Javier Donate-Correa ◽  
Raúl Morales-Febles ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Renal Transplant ◽  
Cell Function ◽  
Cell Damage ◽  
Current Evidence ◽  
Renal Transplant Recipients ◽  
Transplant Recipients ◽  
Post Transplant ◽  
Β Cell Function

Post-transplant diabetes mellitus (PTDM) is a frequent and relevant complication after renal transplantation: it affects 20–30% of renal transplant recipients and increases the risk for cardiovascular and infectious events. Thus, understanding pathogenesis of PTDM would help limiting its consequences. In this review, we analyse novel aspects of PTDM, based on studies of the last decade, such as the clinical evolution of PTDM, early and late, the reversibility rate, diagnostic criteria, risk factors, including pre-transplant metabolic syndrome and insulin resistance (IR) and the interaction between these factors and immunosuppressive medications. Also, we discuss novel pathogenic factors, in particular the role of β-cell function in an environment of IR and common pathways between pre-existing cell damage and tacrolimus-induced toxicity. The relevant role of prediabetes in the pathogenesis of PTDM and cardiovascular disease is also addressed. Finally, current evidence on PTDM treatment is discussed.

scholarly journals Prevalence of BK Virus among Iranian Renal Transplant Recipients: A Systematic Review and Meta-Analysis

2020 ◽  
Vol 4 (4) ◽  
pp. 50-61
Author(s):  
Mohsen Ebrahimi ◽  
Alireza Mohebbi ◽  
Mohammad Mostakhdem Hashemi ◽  
Mobina Ashrafi Shahmirzadi ◽  
◽  
...  
Keyword(s):  
Systematic Review ◽  
Renal Transplant ◽  
Meta Analysis ◽  
Bk Virus ◽  
Renal Transplant Recipients ◽  
Transplant Recipients

scholarly journals High Plasma Branched-Chain Amino Acids Are Associated with Higher Risk of Post-Transplant Diabetes Mellitus in Renal Transplant Recipients

2020 ◽  
Vol 9 (2) ◽  
pp. 511 ◽  
Author(s):  
Maryse C. J. Osté ◽  
Jose L. Flores-Guerrero ◽  
Eke G. Gruppen ◽  
Lyanne M. Kieneker ◽  
Margery A. Connelly ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Amino Acids ◽  
Renal Transplant ◽  
Branched Chain Amino Acids ◽  
Resonance Spectroscopy ◽  
Renal Transplant Recipients ◽  
Transplant Recipients ◽  
Post Transplant ◽  
Branched Chain

Post-transplant diabetes mellitus (PTDM) is a serious complication in renal transplant recipients. Branched-chain amino acids (BCAAs) are involved in the pathogenesis of insulin resistance. We determined the association of plasma BCAAs with PTDM and included adult renal transplant recipients (≥18 y) with a functioning graft for ≥1 year in this cross-sectional cohort study with prospective follow-up. Plasma BCAAs were measured in 518 subjects using nuclear magnetic resonance spectroscopy. We excluded subjects with a history of diabetes, leaving 368 non-diabetic renal transplant recipients eligible for analyses. Cox proportional hazards analyses were used to assess the association of BCAAs with the development of PTDM. Mean age was 51.1 ± 13.6 y (53.6% men) and plasma BCAA was 377.6 ± 82.5 µM. During median follow-up of 5.3 (IQR, 4.2–6.0) y, 38 (9.8%) patients developed PTDM. BCAAs were associated with a higher risk of developing PTDM (HR: 1.43, 95% CI 1.08–1.89) per SD change (p = 0.01), independent of age and sex. Adjustment for other potential confounders did not significantly change this association, although adjustment for HbA1c eliminated it. The association was mediated to a considerable extent (53%) by HbA1c. The association was also modified by HbA1c; BCAAs were only associated with renal transplant recipients without prediabetes (HbA1c < 5.7%). In conclusion, high concentrations of plasma BCAAs are associated with developing PTDM in renal transplant recipients. Alterations in BCAAs may represent an early predictive biomarker for PTDM.

Sign in / Sign up

Export Citation Format

Share Document