Preemptive Transplantation and Long-Term Outcome in Living Donor Kidney Transplantation, Single-Center Experience

Joo, Kwon Wook; Shin, Sung Joon; Lee, S.H.; Ha, Jong‐Won; Kim, S.; Kim, Y.S.

doi:10.1016/j.transproceed.2007.07.091

Cited by 22 publications

(8 citation statements)

References 17 publications

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“…Complications due to hemodialysis were mainly cardiovascular disease, malnutrition, chronic inflammatory state, impaired immune response, and insufficient clearance. [10][11][12] Kaul et al reported that the initiation of hemodialysis led to significant improvement in T-cell proliferation, which may be associated with acute cellular rejection episodes. 13 Cacciarelli et al have shown that the incidence of acute rejection episodes was lowest in patients who had the shortest duration of dialysis.…”

Section: Discussionmentioning

confidence: 99%

Comparison of preemptive kidney transplant recipients with nonpreemptive kidney recipients in single center: 5 years of follow-up

Sayın¹,

Çolak²,

Tutal³

et al. 2013

IJNRD

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BackgroundFor suitable patients with end-stage renal disease, kidney transplantation (KT) is the best renal replacement therapy, resulting in lower morbidity and mortality rates and improved quality of life. Preemptive kidney transplantation (PKT) is defined as transplantation performed before initiation of maintenance dialysis and reported to be associated with superior outcomes of graft and patient survival. In our study, we aimed to compare the 5-year outcomes of PKT and nonpreemptive kidney transplantation (NPKT) patients who received KT in our center, to define the differences according to complications, comorbidities, adverse effects, clinical symptoms, periodical laboratory parameters, rejection episodes, graft, and patient survival.MethodsOne hundred kidney transplantation (37 PKT, 63 NPKT) recipients were included in our study. All patients were evaluated for adverse effects, complications, comorbidities, clinical symptoms, monthly laboratory parameters, acute rejection episodes, graft, and patient survival.ResultsAcute rejection episodes were found to be significantly correlated with graft loss in both groups (P = 0.02 and P = 0.01, respectively). Hypertension after transplantation was diagnosed by ambulatory blood pressure measurement in 74 of 100 patients. Twenty-five of 37 (67.6%) of Group 1 (PKT) recipients had hypertension while 54 of 63 (85.4%) of Group 2 (NPKT) had hypertension. The incidence of hypertension between two groups was statistically significant (P = 0.03), but this finding was not correlated to graft survival (P = 0.07). Some patients had serious infections, requiring hospitalization, and were treated immediately. Infection rates between the two groups were 10.8% for Group 1 patients and 31.7% for Group 2 patients and were statistically significant (P = 0.02). Infection, requiring hospitalization, was found to be statistically correlated to graft loss in only NPKT patients (P = 0.00).ConclusionWhile the comparison of PKT and graft and patient survival with NPKT is poorer than we expected, lower morbidity rates of hypertension and infection are similar with recent data. Avoidance of dialysis-associated comorbidities, diminished immune response, and cardiovascular complications are the main benefits of PKT.

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Section: Discussionmentioning

confidence: 99%

Comparison of preemptive kidney transplant recipients with nonpreemptive kidney recipients in single center: 5 years of follow-up

Sayın¹,

Çolak²,

Tutal³

et al. 2013

IJNRD

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“…Be to, IIT taikymas pagerina pacientų gyvenimo kokybę, palyginti su ilgalaike dialize, nepriverčia prisirišti prie hemodializės centro ir yra pigesnis bei labiau ekonomiškai atsiperkantis gydymo būdas nei ilgalaikė pakeičiamoji inkstų terapija dializėmis. Ir vis dėlto nemažai privalumų turintis metodas nėra itin plačiai taikomas dėl iškylančių kliūčių, tokių kaip recipientų sąrašo sudarymo tvarka, donorų trūkumas, neaiškus tinkamiausias taikymo laikas [3][4][5][6][7][8][9][10][11][12]. 1980 metais išankstinė inkstų transplantacija JAV buvo atlikta 395 pacientams (2,2 proc.…”

Section: įVadasunclassified

“…Geriausia gydymo priemone pacientams, sergantiems lėtinės inkstų ligos galutine stadija, jau seniai pripažįstama inkstų transplantacija. Pastaraisiais dešimtmečiais atliekami tyrimai rodo, kad išankstinė inkstų transplantacija naudingumu lenkia visus kitus pakeičiamosios inkstų terapijos būdus, įskaitant ir transplantaciją po ilgalaikės dializės, ir turėtų būti laikoma geriausia gydymo priemone esant lėtinės inkstų ligos galutinei stadijai bei kuo plačiau taikoma [3][4][5][6][7][8][9][10][11][12]. IIT -mąstymo apie lėtinę inkstų ligą ir jos gydymą evoliucijos rezultatas.…”

Section: Kodėl Reikėtų Taikyti Išankstinę Inkstų Transplantaciją?unclassified

Išankstinė transplantacija – pirmas pasirinkimas gydant galutinės stadijos lėtinę inkstų ligą

Daugirdaitė

Rimševičius

Miglinas

2015

Medicinos Teorija Ir Praktika

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santraukaReikšminiai žodžiai: lėtinė inkstų liga, išankstinė inkstų transplantacija. Išankstinė inkstų transplantacija -tai transplantacija, atliekama lėtine inkstų liga sergantiems pacientams, netaikius ilgalaikės inkstų funkciją pavaduojančios terapijos dializėmis. Taip pacientai apsaugomi nuo ilgalaikės dializės sukeliamų komplikacijų. Taip pat geresnis yra tiek recipiento, tiek alografto išgyvenamumas, palyginti su transplantacijomis, atliktomis po ilgalaikės dializės. Tai ekonomiškesnis būdas, padedantis sutaupyti netaikant brangiai kainuojančių dializių, sumažinantis hospitalizacijų dėl dializės komplikacijų skaičių, leidžiantis didesnei daliai darbingų pacientų sugrįžti į darbo rinką po transplantacijos ir neprarasti pajamų, užtikrinantis geresnę pacientų gyvenimo kokybę. Vis dėlto šis nemažai privalumų turintis metodas vis dar nėra plačiai taikomas. Pagrindinės kliūtys -donorų trūkumas, ypač gyvųjų, prastas pacientų informuotumas apie jų ligos gydymo galimybes, neaiškus tinkamiausias išankstinės transplantacijos taikymo laikas. Išankstinė inkstų transplantacija laikoma geriausiu gydymo būdu pacientams, sergantiems lėtinės inkstų ligos galutine stadija, bet rekomenduojama jos taikymą svarstyti dar nepasiekus galutinės stadijos, kad būtų užtikrintas pakankamas laikas donoro ir recipiento ištyrimui iki dializių skyrimo. Įveikus iškylančias kliūtis -skatinant donorystę, pabrėžiant gyvų donorų svarbą, tinkamai informuojant pacientus apie jų gydymo galimybes ir išaiškinant išankstinės transplantacijos naudą, nustatant tinkamiausią taikymo laiką, svarbu šį pakeičiamosios inkstų terapijos metodą paversti plačiai naudojamu pirmo pasirinkimo lėtinės inkstų ligos gydymo būdu.

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“…The advantages of kidney transplantation over dialysis treatment are longer patient survival5 6 and better quality of life 7. Further advantages of transplantation with a graft of a living donor compared with a graft of a deceased donor are often better graft quality and graft and patient survival, shorter waiting time, more convenient scheduling of the operation and a real chance of pre-emptive transplantation 8–11. In the Netherlands, due to the scarcity of organs, pre-emptive transplantation is only possible in practice with an organ from a living donor.…”

Section: Introductionmentioning

confidence: 99%

Factors influencing access to kidney transplantation: a research protocol of a qualitative study on stakeholders’ perspectives

et al. 2019

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IntroductionUnequal access to kidney transplantation is suggested, but no systematic inventory exists about factors influencing access to kidney transplantation. There is an absence of any research that has combined stakeholder perspectives along the complete trajectory of transplantation. The present qualitative study explores the contributing factors from the perspectives of multiple stakeholders in this trajectory, including patients, health professionals and health insurance and financial representatives in the Netherlands. Moreover, stakeholders will be invited to suggesting strategies and solutions for handling the facilitating and hindering factors found. By means of interaction, stakeholder groups will arrive at a consensus for new policymaking in the field of a Dutch transplantation care.Methods and analysisThe different stakeholders’ perspectives and possible solutions will be explored by interviewing in three phases. In the first phase, stakeholders’ group perspectives will be explored with individual interviews and focus group interviews without confrontation of views from other perspectives. In the second phase of focus group interviewing, perspectives will be confronted with the other stakeholders’ perspectives assessed. Finally, in the third phase, stakeholders will be invited to focus group discussions for suggesting solutions to overcome barriers and promote facilitators for improving access to transplantation. Approximately, groups from six to twelve participants per focus group and four to maximal six focus groups will be held per stakeholder, depending on the level of saturation, as prescribed by grounded theory. The interviews will be audio-recorded and transcribed verbatim, and qualitative data will be analysed according to the principles of grounded theory supported by using NVivo software.Ethics and disseminationThe Medical Ethical Committee of Erasmus MC, Rotterdam, The Netherlands, has approved this study. The results will be disseminated in peer-reviewed journals and major international conferences.

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Preemptive Transplantation and Long-Term Outcome in Living Donor Kidney Transplantation, Single-Center Experience

Cited by 22 publications

References 17 publications

Comparison of preemptive kidney transplant recipients with nonpreemptive kidney recipients in single center: 5 years of follow-up

Comparison of preemptive kidney transplant recipients with nonpreemptive kidney recipients in single center: 5 years of follow-up

Išankstinė transplantacija – pirmas pasirinkimas gydant galutinės stadijos lėtinę inkstų ligą

Factors influencing access to kidney transplantation: a research protocol of a qualitative study on stakeholders’ perspectives

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