Hyperamylasemia Post Living Donor Nephrectomy Does Not Relate to Pain

Bellini, Maria Irene; Wilson, Rebekah S; Veitch, P. S.; Brown, Tim; Courtney, Aisling E.; Maxwell, Alexander P.; D’Andrea, Vito; McDaid, James

doi:10.7759/cureus.8217

Cited by 3 publications

(3 citation statements)

References 17 publications

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“…Additionally, the majority of donors are discharged from follow-up relatively quickly given the low incidence of perioperative morbidity and mortality [ 13 , 14 ]. In the UK, long-term follow-up data is largely missing in these patients because their follow-up does not form part of standard clinical practice for the majority of donors.…”

Section: Challenges In the Literature Review Of Living Kidney Donomentioning

confidence: 99%

[Retracted] Prevalence, Mechanisms, Treatment, and Complications of Hypertension Postliving Kidney Donation

Deoraj

Moutzouris

Bellini

2021

BioMed Research International

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Living kidney donors represent a unique population of patients. Potential donors are selected based on the belief that their preoperative fitness is likely to mitigate the risks of long- and short-term harm following uninephrectomy. Studies performed on postdonation outcomes have largely focused on mortality and the risk of end-stage renal failure, but have also investigated secondary outcomes such as cardiovascular morbidity and hypertension. It has been postulated that hypertension is a possible outcome of living kidney donation. A variety of studies have been conducted to investigate the prevalence, epidemiology, mechanisms, treatment strategies, and long-term ramifications of hypertension postdonation. These studies are heterogeneous in their population, design, methodology, and outcome measures and have presented contradicting outcomes. Additionally, the absence of a well-matched control group has made it challenging to interpret and generalise the reported findings. As such, it is not possible to definitively conclude that hypertension occurs at a higher rate among donors than the general population. This article will review the evidence of postdonation hypertension prevalence, mechanisms, treatment, and complications.

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Section: Challenges In the Literature Review Of Living Kidney Donomentioning

confidence: 99%

[Retracted] Prevalence, Mechanisms, Treatment, and Complications of Hypertension Postliving Kidney Donation

Deoraj

Moutzouris

Bellini

2021

BioMed Research International

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“…Another important advantage offered by living donation is that an elective operation allows diligent planning and the presence of additional surgical expertise for complex cases [24]. This might also contribute to better outcomes, independently from the quality of the donor [19], with a standardised elective procedure taking place at an optimal time and that, despite being a major operation, has a minor impact [25] on the recovery of the healthy donor, who usually can plan ahead for time off work, for family care for and for a full recovery.…”

Section: Discussionmentioning

confidence: 99%

Living Donor Kidney Transplantation Improves Graft and Recipient Survival in Patients with Multiple Kidney Transplants

Bellini

Courtney

McCaughan

2020

JCM

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Background: Failed kidney transplant recipients benefit from a new graft as the general incident dialysis population, although additional challenges in the management of these patients are often limiting the long-term outcomes. Previously failed grafts, a long history of comorbidities, side effects of long-term immunosuppression and previous surgical interventions are common characteristics in the repeated kidney transplantation population, leading to significant complex immunological and technical aspects and often compromising the short- and long-term results. Although recipients’ factors are acknowledged to represent one of the main determinants for graft and patient survival, there is increasing interest in expanding the donor’s pool safely, particularly for high-risk candidates. The role of living kidney donation in this peculiar context of repeated kidney transplantation has not been assessed thoroughly. The aim of the present study is to analyse the effects of a high-quality graft, such as the one retrieved from living kidney donors, in the repeated kidney transplant population context. Methods: Retrospective analysis of the outcomes of the repeated kidney transplant population at our institution from 1968 to 2019. Data were extracted from a prospectively maintained database and stratified according to the number of transplants: 1st, 2nd or 3rd+. The main outcomes were graft and patient survivals, recorded from time of transplant to graft failure (return to dialysis) and censored at patient death with a functioning graft. Duration of renal replacement therapy was expressed as cumulative time per month. A multivariate analysis considering death-censored graft survival, decade of transplantation, recipient age, donor age, living donor, transplant number, ischaemic time, time on renal replacement therapy prior to transplant and HLA mismatch at HLA-A, -B and -DR was conducted. In the multivariate analysis of recipient survival, diabetic nephropathy as primary renal disease was also included. Results: A total of 2395 kidney transplant recipients were analysed: 2062 (83.8%) with the 1st kidney transplant, 279 (11.3%) with the 2nd graft, 46 (2.2%) with the 3rd+. Mean age of 1st kidney transplant recipients was 43.6 ± 16.3 years, versus 39.9 ± 14.4 for 2nd and 41.4 ± 11.5 for 3rd+ (p < 0.001). Aside from being younger, repeated kidney transplant patients were also more often males (p = 0.006), with a longer time spent on renal replacement therapy (p < 0.0001) and a higher degree of sensitisation, expressed as calculated reaction frequency (p < 0.001). There was also an association between multiple kidney transplants and better HLA match at transplantation (p < 0.0001). A difference in death-censored graft survival by number of transplants was seen, with a median graft survival of 328 months for recipients of the 1st transplant, 209 months for the 2nd and 150 months for the 3rd+ (p = 0.038). The same difference was seen in deceased donor kidneys (p = 0.048), but not in grafts from living donors (p = 0.2). Patient survival was comparable between the three groups (p = 0.59). Conclusions: In the attempt to expand the organ donor pool, particular attention should be reserved to high complex recipients, such as the repeated kidney transplant population. In this peculiar context, the quality of the donor has been shown to represent a main determinant for graft survival—in fact, kidney retrieved from living donors provide comparable outcomes to those from single-graft recipients.

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“…Surgical techniques recommended are those minimally invasive, in view of the lower impact on donor's morbidity, in comparison with the traditional open approach. Recommended approaches are, therefore, mini-open, laparoscopy (full or hand-assisted), and retroperitoneoscopy [24,25]. More recently, robotic-assisted living donor nephrectomy has been showing the best outcomes in the prevention of excessive manipulation of the kidney during the extraction, but there is a higher overall cost, thus significantly limiting its implementation [26].…”

Section: Surgical Options For Living Donor Nephrectomymentioning

confidence: 99%

Living Kidney Donation: Practical Considerations on Setting Up a Program

et al. 2021

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Living kidney donation represents the best treatment for end stage renal disease patients, with the potentiality to pre-emptively address kidney failure and significantly expand the organ pool. Unfortunately, there is still limited knowledge about this underutilized resource. The present review aims to describe the general principles for the establishment, organization, and oversight of a successful living kidney transplantation program, highlighting recommendation for good practice and the work up of donor selection, in view of potential short- and long-terms risks, as well as the additional value of kidney paired exchange programs. The need for donor registries is also discussed, as well as the importance of lifelong follow up.

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Hyperamylasemia Post Living Donor Nephrectomy Does Not Relate to Pain

Abstract: Bellini et al. This is an open access article distributed under the terms of the Creative Commons Attribution License CC-BY 4.0., which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Cited by 3 publications

References 17 publications

[Retracted] Prevalence, Mechanisms, Treatment, and Complications of Hypertension Postliving Kidney Donation

[Retracted] Prevalence, Mechanisms, Treatment, and Complications of Hypertension Postliving Kidney Donation

Living Donor Kidney Transplantation Improves Graft and Recipient Survival in Patients with Multiple Kidney Transplants

Living Kidney Donation: Practical Considerations on Setting Up a Program

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