Extended Criteria Donor Kidney Transplantation: Comparative Outcome Analysis Between Single versus Double Kidney Transplantation at 5 Years

Lucarelli, Giuseppe; Bettocchi, Carlo; Battaglia, Michele; Impedovo, S.; Vavallo, Antonio; Grandaliano, Giuseppe; Castellano, Giuseppe; Fp, Schena; Selvaggi, Fp; Ditonno, Pasquale

doi:10.1016/j.transproceed.2010.03.059

Cited by 39 publications

(35 citation statements)

References 17 publications

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“…Our selection criteria, based on this strategy, have shown good patient and graft survival rates at 1 (90% and 84%) and 5 (84% and 81%) years. In a comparable size of DKT (41 patients), Lucarelli et al has shown patient survivals for DKT at 1 and 5 years of 92% and 89%, which was equivalent to those for SKT; however, graft survival for DKT was higher than for SKT, at 100% and 89% at 1 and 5 years, respectively [9]. Analysis of Organ Procurement and Transplantation Network/United Network for Organ Sharing data in 2008 also demonstrated graft survival at 79.8% at 3 years and DGF rate 29.3% for 625 DKTs, which was equivalent to our series graft survival with lower DGF rate [10].…”

Section: Discussionmentioning

confidence: 97%

Dual Kidney Transplantation: A Single-Center Experience

Aawsaj

Dosani

Talbot

2015

Transplantation Proceedings

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Section: Discussionmentioning

confidence: 97%

Dual Kidney Transplantation: A Single-Center Experience

Aawsaj

Dosani

Talbot

2015

Transplantation Proceedings

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“…Preimplantation biopsy grading of the severity of baseline chronic kidney injury can, by providing a framework for either discarding deceased donor kidneys or allocating as single or dual transplants, improve outcomes of 'marginal' or extended criteria kidneys (7,17,19). However, the values of the Remuzzi score that determine single or dual implantation were derived from a hypothetical evaluation of the minimum required nephron mass, and the precise cutoff points of the score are still debated and have yet to be validated clinically (20,21).…”

Section: Discussionmentioning

confidence: 99%

Baseline Donor Chronic Renal Injury Confers the Same Transplant Survival Disadvantage for DCD and DBD Kidneys

Kosmoliaptsis

Salji

Bardsley

et al. 2015

American Journal of Transplantation

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Histological assessment of baseline chronic kidney injury may discriminate kidneys that are suitable for transplantation, but has not been validated for appraisal of donation after circulatory death (DCD) kidneys. 'Time-zero' biopsies for 371 consecutive, solitary, deceased-donor kidneys transplanted at our center between 2006 and 2010 (65.5% DCD, 34.5% donation after brain death [DBD]) were reviewed and baseline chronic degenerative injury scored using Remuzzi's classification. High scores correlated with donor age and extended criteria donors (42% of donors), but the spectrum of scores was similar for DCD and DBD kidneys. Transplant outcomes for kidneys scoring from 0 to 4 were comparable (1 and 3 year graft survival 95% and 92%), but were much poorer for kidneys scoring !5, with 1 year graft survival only 73%, and 12.5% suffering primary nonfunction. Critically, high Remuzzi scores conferred the same survival disadvantage for DCD and DBD kidneys. On multi-variable regression analysis, time-zero biopsy score was the only independent predictor for graft survival, whereas one-year graft estimated glomerular filtration rate (eGFR) correlated with donor age and biopsy score. In conclusion, the relationship between severity of chronic kidney injury and transplant outcome is similar for DCD and DBD kidneys. Kidneys with Remuzzi scores of 4 can be implanted singly with acceptable results.

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“…Additional studies have documented that KIM-1 and its urinary derivative are upregulated in various kidney diseases including diabetic nephropathy, focal glomerulosclerosis, membranoproliferative glomerulonephritis, and IgA nephropathy [51]. Urinary KIM-1 also predicts graft loss in kidney transplant recipients [52–54] and this predictive role has an important role in the era of kidney transplants from expanded criteria donors [55, 56]. …”

Section: Kidney Injury Molecule-1 (Kim-1)mentioning

confidence: 99%

Emerging Urinary Markers of Renal Injury in Obstructive Nephropathy

Lucarelli

Mancini

Galleggiante

et al. 2014

BioMed Research International

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The effects of obstruction on renal function are the consequence of many factors that profoundly alter all components of glomerular function. Besides the acute effects on glomerular filtration rate and tubule function, a chronic obstruction induces tubular and interstitial injury that results from the activation of different pathways. The progression of tubulointerstitial injury leads to chronic renal damage characterized by tubular atrophy, inflammatory cell infiltration, and interstitial fibrosis. Obstructive nephropathy is an evolving disease in which the renal damage continues even after relief of the obstruction. In particular, it has been demonstrated that the time of relief is the most important factor in predicting long-term renal function deterioration. In this setting, the EGF/MCP-1 ratio, urinary NGAL, and urinary KIM-1 are useful early biomarkers of progressive renal damage and could have a potential role in predicting the long-term renal outcome. This minireview summarizes the role of these emerging urinary biomarkers of obstructive nephropathy based on the current understanding of the pathophysiology of renal injury.

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Extended Criteria Donor Kidney Transplantation: Comparative Outcome Analysis Between Single versus Double Kidney Transplantation at 5 Years

Cited by 39 publications

References 17 publications

Dual Kidney Transplantation: A Single-Center Experience

Dual Kidney Transplantation: A Single-Center Experience

Baseline Donor Chronic Renal Injury Confers the Same Transplant Survival Disadvantage for DCD and DBD Kidneys

Emerging Urinary Markers of Renal Injury in Obstructive Nephropathy

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