Living-donor kidney transplant: guidelines with updated evidence

Frutos, M.Á.; Crespo, Marta; Valentín, María de la Oliva; Hernández, Domingo; Sequera, Patricia de; Domínguez‐Gil, Beatriz; Pascual, Julio

doi:10.1016/j.nefroe.2022.01.009

Cited by 3 publications

(3 citation statements)

References 19 publications

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“…Currently, polymer clips are normally used in radical nephrectomy and are also used in LDN in some centres. They are considered safe when properly located, with a 2-mm separation between the two polymer clips at a distance of a few millimetres from the section in the artery [37]. Several studies have evaluated the outcomes of vascular control devices in laparoscopic nephrectomy carried out due to benign and malignant conditions.…”

Section: Discussionmentioning

confidence: 99%

Vascular closure devices in living‐donor nephrectomy: a much‐needed systematic review and meta‐analysis focusing on safety

et al. 2023

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ObjectiveTo assess the safety of vascular closure devices in living‐donor nephrectomy (LDN), as staplers and non‐transfixion techniques (polymer locking and metal clips) are the methods employed to secure the renal vessels during laparoscopic and robotic LDN, but the use of clips has come into question since the United States Food and Drug Administration and manufacturers issued a contraindication.MethodsA systematic review and meta‐analysis were conducted to assess the safety of vascular closure devices (International Prospective Register of Systematic Reviews [PROSPERO] registration: CRD42022364349). The PubMed, Scopus, the Excerpta Medica dataBASE (EMBASE), and the Literatura Latino‐Americana e do Caribe em Ciências da Saúde (LILACS) databases were searched in September 2022. For comparative and non‐comparative studies, incidence estimates and odds ratios (ORs), respectively, for the main variables regarding safety of vascular closure devices were pooled by using random effects meta‐analyses. Quality assessment of the included comparative studies was conducted using the Risk Of Bias In Non‐randomised Studies of Interventions (ROBINS‐I) tool.ResultsOf the 863 articles obtained, data were retrieved from 44 studies, which included 42 902 patients. In non‐comparative studies, the pooled estimate rates for device failure, severe haemorrhage rate, conversion to open surgery, and mortality were similar for both clips and staplers. Regarding the meta‐analyses for comparative studies (three studies), there were no significant differences between the two groups for the severe haemorrhage rate (OR 0.57, 95% confidence interval [CI] 0.18–1.75; P = 0.33), conversion to open surgery (OR 0.35, 95% CI 0.08–1.54; P = 0.16), or death rate (OR 3.64, 95% CI 0.47–28.45; P = 0.22). Based on weak evidence, device failure was lower in the polymer clip group (OR 0.41, 95% CI 0.23–0.75; P = 0.00).ConclusionsThis study has confirmed that there is no evidence for the superiority of any vascular closure device in terms of safety in LDN. Standardised recommendations for vascular control in this context should be carefully designed and prospectively evaluated.

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Section: Discussionmentioning

confidence: 99%

Vascular closure devices in living‐donor nephrectomy: a much‐needed systematic review and meta‐analysis focusing on safety

et al. 2023

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“…Ana Merino Ribas 1,2,3 Susana Sampaio 1,4 Nádia Silva 4 Joana Campos 1 Manuel Pestana 1,4,5 Benedita Sampaio Maia…”

Section: Conflict Of Interest Statementunclassified

“…3 In the last decade, several alerts have been raised on the long-term risks of living kidney donors (LKD) regarding kidney and cardiovascular disease. 4 While considering these warnings, additional tools should be explored to help to assess these risks in LKD. Any impact on the human micro- for sample comparison and statistical analyses.…”

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confidence: 99%

The stability of the gut, oral, and circulating microbiomes in living kidney donors: A 2 years prospective study

Araújo

Merino-Ribas

Sampaio

et al. 2023

Clinical Transplantation

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Technological Checklist for Kidney and Liver Transplantation in a Multidisciplinary Hospital. Clinical Protocol

Yaremin,

Pushkin,

Navasardyan

et al. 2024

vmirvz

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This clinical protocol delineates the technological requirements for performing kidney and liver transplantation procedures in a multidisciplinary hospital setting. The protocol has been developed based on clinical guidelines from leading international societies and has been approved by the Samara Regional Branch of the Interregional Public Organization "Society of Transplantologists" (Protocol No. 11 dated July 1, 2024). It is recommended for use in assessing a hospital's readiness to implement transplantation programs. The technologies specified in the protocol may be implemented either through the hospital's own resources or via agreements with other healthcare institutions or through outsourcing arrangements.

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Living-donor kidney transplant: guidelines with updated evidence

Cited by 3 publications

References 19 publications

Vascular closure devices in living‐donor nephrectomy: a much‐needed systematic review and meta‐analysis focusing on safety

Vascular closure devices in living‐donor nephrectomy: a much‐needed systematic review and meta‐analysis focusing on safety

The stability of the gut, oral, and circulating microbiomes in living kidney donors: A 2 years prospective study

Technological Checklist for Kidney and Liver Transplantation in a Multidisciplinary Hospital. Clinical Protocol

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