Current Issue : October - December Volume : 2018 Issue Number : 4 Articles : 6 Articles
Introduction and Objectives. Renal autotransplantation is a kidney-saving surgical procedure used in selected patients. The\npurpose of this report is to review nine typical and atypical indications for kidney autotransplantation and evaluate its effectiveness\nin maintaining kidney function and avoiding cancer recurrence. Materials and Methods. From 1999 till 2014, nine renal\nautotransplantations were performed in our center. A retrospective case review was done. Four of nine patients had a solitary\nfunctioning kidney. Typical indications for autotransplantation included extended ureteric disease in 5 patients, intrasinusal\ntumor on a solitary kidney in 1 patient, and renal artery aneurysm in 1 patient. Atypical indications consisted in bilateral urothelial\ntumors in 1 patient and interrupted live kidney transplantation in 1 patient. Mean cold ischemia time was 209 minutes. Demographic\nfactors, indications, renal function before and after surgery, and in the long term, cancer recurrence and disease-free\nsurvival were evaluated. Results. Renal function was maintained in 8 patients during the early follow-up. No serious complications\noccurred in the postoperative period. Median duration of follow-up was 50 months. In 4 patients with a normal contralateral\nkidney, mean preoperative and at discharge creatinine clearance were 105.45 ml/min and 121.02 ml/min, respectively. Although\nvalues showed an improvement in the kidney function, the difference was not significant (p value 0.3). In the other 4 patients with\na solitary kidney, mean discharge creatinine clearance was 99.24 ml/min surprisingly higher than the preoperative value\n96.92 ml/min. At the last follow-up, kidney function was preserved for the two groups (normal contralateral kidney/solitary\nkidney) with relatively stable creatinine clearance values: 108.45 ml/min and 85.9 ml/min, respectively. No patients required\nsecondary dialysis. Conclusion. Renal autotransplantation is a rare, safe, and effective surgical procedure for the treatment of\ncomplex urologic conditions. In some instances, it may be of great utility for kidney salvage in some carefully selected patients....
The aim of this study is to elucidate the biogenetic modification of donor and recipient interleukin-28B (IL-28B) genotypes in\nliver graft biopsies after living donor liver transplantation (LDLT) for chronic hepatitis C virus- (HCV-) related, end-stage liver\ndisease. Fifty liver graft biopsies were collected from recipients during LDLT treatment for HCV-related, end-stage liver disease.\nDNA was extracted from all 50 liver tissues, and the IL-28B single-nucleotide polymorphisms (SNPs) rs8099917 and rs12979860\nwere studied for allelic discrimination by real-time PCR analysis. Blood samples were obtained from donors and recipients on\npostoperative day 0 (POD0), POD7, and POD30. We randomly selected five liver biopsies and isolated the hepatocytes by laser\ncapture microdissection (LCM) to evaluate genotype modifications resulting from LDLT. After LDLT, the IL-28B SNP rs8099917\nwas identified not only in the liver graft biopsies and donors� sera (TT = 41 : 43; GT = 9 : 5; GG = 0 : 2), but also in liver graft biopsies\nand recipients� sera on POD0 (TT = 41 :44; GT = 9:4; GG = 0:2), POD7 (TT = 41 :30; GT = 9: 18;GG = 0:2), and POD30 (TT =\n41 : 29; GT = 9 : 19; GG = 0 : 2). A significant difference was observed between the rs8099917 allele frequencies of liver graft biopsies\nand recipients� sera on POD30 (...
Since the first kidney transplant was performed in 1954 immense progress has\nbeen made in the world of transplantation. Modern immunosuppressive regimens\nhave led to increasing graft and patient survival after solid organ\ntransplantation. Furthermore, these advances have opened the door to new\nfields of transplantation such as composite tissue allotransplantation. These\ndevelopments have made possible numerous types of transplantation including,\nbut not limited to face, penile, and uterine transplantation. Moreover,\ninnovations in genetic engineering and stem cell technology have contributed\nto rapid developments in the fields of xenotransplantation and the engineering\nof functional organs from induced pluripotent stem cells. As the prevalence\nof chronic diseases rises, so too will the necessity for organ transplantation.\nThus, the transplant innovations of the modern era need to be expanded\nupon so as to continue to discover new ways to address organ shortages and\nthe complications of transplantation....
As a result of donation after circulatory death liver graftsââ?¬â?¢ poor tolerance to cold storage, there has been increasing research interest\nin normothermic machine perfusion. This study aims to systematically review the current literature comparing normothermic\nperfusion to cold storage in donation after circulatory death liver grafts and complete a meta-analysis of published large animal\nand human studies. A total of nine porcine studies comparing cold storage to normothermic machine perfusion for donation after\ncirculatory death grafts were included for analysis. There was a significant reduction in AST (mean difference âË?â??2291 U/L, CI (âË?â??3019,\nâË?â??1563); P ââ?°Â¤ 0.00001) and ALT (mean difference âË?â??175U/L, CI (âË?â??266, âË?â??85); ...
Background. Focal segmental glomerulosclerosis (FSGS) often develops rapidly and frequently progresses to renal failure, while\nthe recurrence rate after kidney transplantation is 20ââ?¬â??50%. We performed low-density lipoprotein (LDL) apheresis before kidney\ntransplantation in FSGS patients to prevent recurrence. Methods. Five adult patients with chronic renal failure due to FSGS\nundergoing living related donor kidney transplantation were investigated retrospectively. LDL apheresis was done 1-2 times before\ntransplantation. Postoperative renal function and recurrence of FSGS were assessed. Results. The patientswere two men and three\nwomen aged 24 to 41 years. The observation period ranged from 60 days to 22 months. Preoperative LDL apheresis was performed\nonce in one patient and twice in four patients. Blood LDL cholesterol levelswere normal before LDL apheresis and remained normal\nboth after LDL apheresis and after kidney transplantation. Additional LDL apheresis was performed once in one patient with mild\nproteinuria after transplantation.The renal graft survived in all patients and there was no evidence of recurrent FSGS. Conclusions.\nAlthough the observation period was short, FSGS did not recur in all 5 patients receiving preoperative LDL apheresis. These results\nsuggest that LDL apheresis can be effective in preventing recurrence of FSGS after kidney transplantation....
Background. Grafts from elderly donors (ECD) are increasingly allocated to single (SKT) or dual (DKT) kidney transplantation\naccording to biopsy score. Indications and benefits of either procedure lack universal agreement. Methods. A total of 302 ECDtransplants\nin period fromJan 1, 2000, to Dec 31, 2015, were allocated to SKT (SKTpre) on clinical grounds alone (before Dec 2010,\npre-DKT era, ...
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