Tag Archives: renal transplant
Chronic Kidney Disease After Liver Transplantation: Pretransplantation Risk Factors and Predictors During Follow-Up
Hemodialysis.com eInterview with Prof Manuela Merli
Dott. Michela Giusto
Dept of Clinical Medicine
Sapienza University of Rome Italy
Hemodialysis.com: What are the main findings of the study?
Prof Merli: The increasing number of long-term survivors of liver transplant raises the question of increased number of patients developing chronic kidney disease (CKD) and end-stage-renal diseases after the transplant. Despite the wide recognition of the multifactorial etiology of post-liver transplant renal dysfunction, a validated predictive score for CKD after liver transplant is still lacking. For this reason we chose to perform a time dependent multivariate analysis. This type of analysis is the best way of taking into account the predictive value of factors occurring during follow-up, and at the same time of considering the changes that may occur in the variables already available at the time of transplantation. We define CKD as estimated GFR<60ml/min in two subsequent controls that were at least 3 month apart, according to the position statement from the Kidney Disease Improving Global Outcome. This cut-off identifies patients with at least a moderate CKD which are those in whom early recognition is important to avoid further nephrotoxic insults.
Marie Benz, MD on Google+Recipient-related predictors of kidney transplantation outcomes in the elderly
Hemodialysis.com Author’s Interview with:
Dr. Kalantar-Zadeh, MD, MPH, PhD
Professor & Chief, Division of Nephrology & Hypertension
University of California Irvine, School of Medicine
Adjunct Professor of Epidemiology, Dept. Epidemiology,
UCLA Fielding School of Public Health, Los Angeles, CA
Parta Hatamizadeh, M.D.
Nephrology Fellow
University of Michigan
Hemodialysis.com: What are the main findings of the study?
Answer: One of the major findings of this study was that the increase in all-cause mortality with advancing age was dramatically attenuated in kidney transplant recipients compared to the general population. The other finding was that among the senior patients (>65 year old) kidney transplant outcome was better in the older recipients compared to the younger seniors and was the best in those older than75 years. Among senior kidney transplant recipients, diabetes had a negative effect on patient survival in all patients but a negative effect on graft survival only in those between 65 and <70 years of age. Female senior recipients generally survived better than their male counterparts but their transplanted kidneys survived less. Obesity was associated with higher graft failure in the the recipients between 65 and70 years old and finally, in the very old recipients (>75 years), Hispanics had the best outcomes.
Effect of donor age and cold storage time on outcome in recipients of kidneys donated after circulatory death in the UK
Hemodialysis.com Author Interview: Dr. Dominic Summers MBBChir
Department of Surgery, School of Clinical Medicine
University of Cambridge, Cambridge, UK
Hemodialysis.com: What are the main findings of the study?
Dr. Summers:
Firstly, we were able to confirm our (and others) previous work that showed that there seems to be very little difference in survival and graft function of kidneys from donation after circulatory death (DCD) and kidneys from donation after brain death (DBD).
Secondly, we were able to show that, while kidneys from older donors perform less well than kidneys from younger donors, there is no evidence that this is a particular problem for DCD donor kidneys.
Finally, we showed that DCD donor kidneys are more susceptible to cold ischemic injury.
The Impact of Deceased Donor Kidney Risk Significantly Varies by Recipient Characteristics
Hemodialysis.com Author Interview:
Jesse D. Schold, PhD
Associate Staff in the Department of Quantitative Health Sciences and
Director of Outcomes Research for the Kidney Transplant Program
Cleveland Clinic, Cleveland, Ohio.
Hemodialysis.com: What are the main findings of the study?
Dr. Schold: The primary findings demonstrated that donor quality has a significantly different effect depending on recipient characteristics. In particular, recipient race, age and diabetic status strongly modified the impact of donor quality.
Molecular Diagnosis of Antibody-Mediated Rejection in Human Kidney Transplants
Hemodialysis.com Author Interview:
Philip Halloran, MD University of Alberta, Canada
Professor, Division of Nephrology
Hemodialysis.com: What are the main findings of the study?
Dr. Halloran: The diagnosis of antibody-mediated rejection (ABMR) is difficult and the pathologists cannot agree on the criteria.
This is critical because ABMR is the major cause of late kidney transplant failure. Histology, C4d staining, and HLA antibody (DSA) are all required but each is problematic. Thus we studied whether microarray measurements of mRNA in the biopsy (one biopsy core) could make the diagnosis.
