DOCSLIB.ORG

Kidney Transplantationcjasn Epress

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Kidney Transplantationcjasn Epress Kidney TransplantationCJASN ePress. Published on April 2, 2021 as doi: 10.2215/CJN.15070920 Long-Term Management Challenges Thinking Outside the Box: Novel Kidney Protective Strategies in Kidney Transplantation Hassan N. Ibrahim,1 Dina N. Murad,1 and Greg A. Knoll2 Abstract Despite the reduction in the incidence of acute rejection, a major risk factor for graft loss, there has been only modest improvement in long-term graft survival. Most cases of kidney graft loss have an identifiable cause that is not 1 idiopathic fibrosis/atrophy or calcineurin inhibitor nephrotoxicity. Distinct immunologic and nonimmunologic Division of Renal Diseases and factors conspire to lead to a common pathway of allograft fibrosis. It remains plausible that mitigating Hypertension, nonimmunologic damage using strategies proven effective in native kidney disease may yield benefit in kidney Department of transplantation. In this review, we will focus on nonimmunologic aspects of kidney transplant care that may prove Medicine, Houston to be valuable adjuncts to a well-managed immunosuppression regimen. Topics to be addressed include the roles of Methodist Hospital, Houston, Texas hypertension and agents used to treat it, lipid lowering, sodium and water intake, elevated uric acid, metabolic 2Division of acidosis, and the use of sodium-glucose cotransporter 2 inhibitors on long-term kidney transplant health. Nephrology, CJASN 17: ccc–ccc, 2022. doi: https://doi.org/10.2215/CJN.15070920 Department of Medicine, Ottawa Hospital and Ottawa Hospital Research Introduction nonimmunologic strategies, often explored and used Institute, Ottawa, Avoidance of premature graft failure remains a key first in the nontransplant setting, remain important Ontario, Canada goal in the management of kidney transplant recip- options for the management of kidney transplant ients. Graft loss is associated with a nearly four-fold recipients. In this review, we will focus on nonimmu- Correspondence: higherriskofdeathcomparedwiththosewitha nologic aspects of kidney transplant care that may be Dr.HassanN.Ibrahim, 6550 Fannin Street, functioning graft (1,2). The Standardized Outcomes in overlooked and perhaps overshadowed by the focus Suite 1001, Houston, Nephrology—Kidney Transplantation group has on immunosuppression-based interventions. TX 77030. Email: identified kidney transplant survival as the most hnibrahim@ important priority for both patients and health care houstonmethodist.org providers (3). Preventing graft loss was the top Hypertension and Allograft Outcome priority, even over death, as transplant recipients BP lowering in both the general and CKD popula- were more concerned with quality rather than quan- tions has been associated with many beneficial effects, tity of life. Kidney transplant outcomes vary by including reduction in cardiovascular events and program and region. Registry data from 1988 to death. Data from the Systolic Blood Pressure Inter- 2014 on over 350,000 kidney transplant recipients vention Trial (SPRINT) suggest that even lower BP from the United States, the United Kingdom, Aus- targets (i.e., ,120 mm Hg) may be associated with tralia, and New Zealand are instructive (4). Long-term improved clinical outcomes, even for those with CKD ‐ adjusted graft failure risk (conditional on 1 year (5). Although the supportive data for BP lowering are fi function) was signi cantly higher in the United States more consistent for cardiovascular events and death, compared with Australia, New Zealand, and the there are also beneficial effects of BP lowering on ‐ United Kingdom. Long term kidney graft outcomes kidney outcomes. In the nontransplant CKD popula- were, however, approximately 25% worse in the tion, a meta-analysis of 11 randomized trials found United States compared with the three other devel- that more intensive BP lowering was associated with a oped nations, perhaps due to major differences in significant reduction in kidney failure events (defined health care delivery systems and extent of immuno- as either a composite of doubling of serum creatinine suppressive medications coverage. If the reasons level and 50% decline in GFR or kidney failure) (6). In behind these inferior outcomes in the United States the kidney transplant population, unfortunately, we can be firmly determined, appropriate changes may do not have similar supportivedata.Thereare result in substantial benefits to both patients and the observational data showing that a lower BP 1 year health care system in the United States. after transplantation is associated with an improve- Many strategies have been used with the intended ment in long-term graft survival, but perhaps the best goal of preserving kidney function and prolonging available evidence comes from the Folic Acid for graft survival. These include adjustments in immu- Vascular Outcome Reduction study, which showed a nosuppression to prevent and treat rejection as well as direct graded relation between systolic BP and future prevent the development of donor-specificantibody. risk of cardiovascular disease and all-cause mortality In addition to these immunologic approaches, (7,8). Unfortunately, there have been no interventional www.cjasn.org Vol 17 January, 2022 Copyright © 2022 by the American Society of Nephrology 1 2 CJASN trials evaluating whether lowering BP, to a specific target, 0.49 to 1.18) or doubling of serum creatinine (RR, 0.84; is associated with improvement in any clinically important 95% CI, 0.51 to 1.39) compared with controls. The major outcomes, such as allograft survival. Despite the lack of limitations of this systematic review are the relatively strong evidence from randomized trials in transplant short follow-up of the included trials (five trials with recipients, it seems reasonable to target a BP level similar ,2-year follow-up and overall range of follow-up of to other high-risk patients. A target BP of ,130/80 mm Hg 1–10 years), low death events (n571), and a low number has been recommended in the Kidney Disease Improving of transplant failure events (n572). KDIGO is currently Global Outcomes (KDIGO) guideline on post-transplant updating its BP guidelines for CKD. In a draft that was management (9). A similar target for kidney transplant circulated for public comment, an updated systematic recipients was suggested in the 2012 KDIGO clinical review suggested that ARB use, but not ACEi, is asso- practice guideline for the management of BP in CKD as ciated with a reduction in kidney allograft loss. This well as in the recently published American College of finding suggests that in addition to CCBs, ARB use for Cardiology/American Heart Association BP guidelines the management of hypertension may be preferred over (10,11). Until further evidence accumulates, a lower other agents given this salutary effect on graft survival. “SPRINT-like” target of ,120 mm Hg may not be an Attheendoftheday,however,atrialwith.10,000 appropriate goal given the higher risk of AKI and GFR recipients would be needed to prove superiority of renin- decline seen with more intensive BP control (12,13). These angiotensin-aldosterone system (RAAS) blockade in trans- concerns may conceivably be more serious in the setting of plant recipients. lack of robust autoregulation of renal blood flow in the Although RAAS blockade has been shown to prevent denervated allograft. progression of proteinuric kidney disease, it has never been shown to reduce structural damage or kidney failure in patients with preserved kidney function akin to that of a Choice of Antihypertensive Agent newly transplanted kidney. In fact, neither losartan nor Although there is no direct randomized trial–driven enalapril prevented expansion of the mesangial glomerular evidence to support a certain BP target in kidney transplant volume in normoalbuminuric, normotensive, normal, or recipients, there are data suggesting that calcium channel high GFR type 1 diabetic subjects who were treated for blockers (CCBs) may be the preferred antihypertensive in 5 years (19). The failure of RAAS blockade to show benefit this population (14). In a systematic review of 60 trials in transplantation similar to that observed in native kidney (n53802 patients), with 29 trials (n52262 recipients) com- disease may reflect the small sizes of the trials conducted paring CCBs with placebo or no treatment, ten trials and the low overall event rate, but it is also conceivable that involving 445 recipients comparing angiotensin- RAAS is not overly activated in kidney transplantation converting enzyme inhibitors (ACEis) with placebo or no (20–22). In the 5-year-long randomized trial of losartan treatment, and seven trials (n5405) comparing ACEis with versus placebo, we measured plasma renin activity (PRA) CCBs, Cross et al. (14) found that CCBs compared with and plasma aldosterone annually in 153 kidney transplant placebo or no treatment were associated with a 25% lower recipients. PRA and aldosterone were in the normal range risk of graft loss (relative risk [RR], 0.75; 95% confidence the entire duration of the trial; those on losartan exhibited interval [95% CI], 0.57 to 0.99) and an improvement in GFR higher PRA but similar plasma aldosterone levels (16,22). (mean difference, 4.5 ml/min per 1.73 m2;95%CI,2.2to Furthermore, PRA and plasma aldosterone levels did not 6.7). Although this supports the notion that CCBs are the vary by immunosuppressive agents used, and neither preferred antihypertensive agents in preventing allograft baseline nor serial PRA or aldosterone were associated failure, it is worth noting
Load more

Recommended publications
  • Organ Transplant Discrimination Against People with Disabilities Part of the Bioethics and Disability Series
    Organ Transplant Discrimination Against People with Disabilities Part of the Bioethics and Disability Series National Council on Disability September 25, 2019 National Council on Disability (NCD) 1331 F Street NW, Suite 850 Washington, DC 20004 Organ Transplant Discrimination Against People with Disabilities: Part of the Bioethics and Disability Series National Council on Disability, September 25, 2019 This report is also available in alternative formats. Please visit the National Council on Disability (NCD) website (www.ncd.gov) or contact NCD to request an alternative format using the following information: [email protected] Email 202-272-2004 Voice 202-272-2022 Fax The views contained in this report do not necessarily represent those of the Administration, as this and all NCD documents are not subject to the A-19 Executive Branch review process. National Council on Disability An independent federal agency making recommendations to the President and Congress to enhance the quality of life for all Americans with disabilities and their families. Letter of Transmittal September 25, 2019 The President The White House Washington, DC 20500 Dear Mr. President, On behalf of the National Council on Disability (NCD), I am pleased to submit Organ Transplants and Discrimination Against People with Disabilities, part of a five-report series on the intersection of disability and bioethics. This report, and the others in the series, focuses on how the historical and continued devaluation of the lives of people with disabilities by the medical community, legislators, researchers, and even health economists, perpetuates unequal access to medical care, including life- saving care. Organ transplants save lives. But for far too long, people with disabilities have been denied organ transplants as a result of unfounded assumptions about their quality of life and misconceptions about their ability to comply with post-operative care.
    [Show full text]
  • The Story of Organ Transplantation, 21 Hastings L.J
    Hastings Law Journal Volume 21 | Issue 1 Article 4 1-1969 The tS ory of Organ Transplantation J. Englebert Dunphy Follow this and additional works at: https://repository.uchastings.edu/hastings_law_journal Part of the Law Commons Recommended Citation J. Englebert Dunphy, The Story of Organ Transplantation, 21 Hastings L.J. 67 (1969). Available at: https://repository.uchastings.edu/hastings_law_journal/vol21/iss1/4 This Article is brought to you for free and open access by the Law Journals at UC Hastings Scholarship Repository. It has been accepted for inclusion in Hastings Law Journal by an authorized editor of UC Hastings Scholarship Repository. The Story of Organ Transplantation By J. ENGLEBERT DUNmHY, M.D.* THE successful transplantation of a heart from one human being to another, by Dr. Christian Barnard of South Africa, hias occasioned an intense renewal of public interest in organ transplantation. The back- ground of transplantation, and its present status, with a note on certain ethical aspects are reviewed here with the interest of the lay reader in mind. History of Transplants Transplantation of tissues was performed over 5000 years ago. Both the Egyptians and Hindus transplanted skin to replace noses destroyed by syphilis. Between 53 B.C. and 210 A.D., both Celsus and Galen carried out successful transplantation of tissues from one part of the body to another. While reports of transplantation of tissues from one person to another were also recorded, accurate documentation of success was not established. John Hunter, the father of scientific surgery, practiced transplan- tation experimentally and clinically in the 1760's. Hunter, assisted by a dentist, transplanted teeth for distinguished ladies, usually taking them from their unfortunate maidservants.
    [Show full text]
  • Methods I N Molecular Biology
    M ETHODS IN M OLECULAR B IOLOGY Series Editor John M. Walker School of Life and Medical Sciences University of Hertfordshire Hatfield, Hertfordshire, AL10 9AB, UK For further volumes: http://www.springer.com/series/7651 HLA Typing Methods and Protocols Edited by Sebastian Boegel Johannes Gutenberg University of Mainz, Mainz, Germany Editor Sebastian Boegel Johannes Gutenberg University of Mainz Mainz, Germany ISSN 1064-3745 ISSN 1940-6029 (electronic) Methods in Molecular Biology ISBN 978-1-4939-8545-6 ISBN 978-1-4939-8546-3 (eBook) https://doi.org/10.1007/978-1-4939-8546-3 Library of Congress Control Number: 2018943706 © Springer Science+Business Media, LLC, part of Springer Nature 2018 This work is subject to copyright. All rights are reserved by the Publisher, whether the whole or part of the material is concerned, specifically the rights of translation, reprinting, reuse of illustrations, recitation, broadcasting, reproduction on microfilms or in any other physical way, and transmission or information storage and retrieval, electronic adaptation, computer software, or by similar or dissimilar methodology now known or hereafter developed. The use of general descriptive names, registered names, trademarks, service marks, etc. in this publication does not imply, even in the absence of a specific statement, that such names are exempt from the relevant protective laws and regulations and therefore free for general use. The publisher, the authors and the editors are safe to assume that the advice and information in this book are believed to be true and accurate at the date of publication. Neither the publisher nor the authors or the editors give a warranty, express or implied, with respect to the material contained herein or for any errors or omissions that may have been made.
    [Show full text]
  • Spain, France and Italy Are to Exchange Organs for Donation Chains
    Translation of an article published in the Spanish newspaper ABC on 10 October 2012 O.J.D.: 201504 Date: 10/10/2012 E.G.M.: 641000 Section: SOCIETY Pages: 38, 39 ----------------------------------------------------------------------------------------------------------------- This is what happened in Spain’s first ‘crossover’ transplant [For diagram see original article] Altruistic donor The chain started with the kidney donation from a ‘good Samaritan’ going to a recipient in a couple. The wife of the first recipient donated her kidney to a sick person in a second couple. The wife of the second recipient donated her kidney to a third patient on the waiting list. On the waiting list The final recipient, selected using medical criteria, was on the waiting list to receive a kidney from a deceased donor for three years. Spain, France and Italy are to exchange organs for donation chains ► The creation of this type of ‘common area’ in southern Europe will increase the chances of finding a donor match CRISTINA GARRIDO BRUSSELS | Stronger together. Although there are many things on which we find it difficult to agree, this time the strategy was clear. Spain, France and Italy have signed the Southern Europe Transplant Alliance to promote their successful donation and transplant system – which is public, coordinated and directly answerable to the Ministries of Health, as compared to the private models of central and northern Europe – to the international bodies. ‘We (Spain, France and Italy) decided that we had to do something together because we have similar philosophies, ethical criteria and structures and we could not each go our own way given how things are in the northern countries’, explained Dr Rafael Matesanz, Director of the Spanish National Transplant Organisation, at the seminar on donations and transplants organised by the European Commission in Brussels yesterday.
    [Show full text]
  • Current Practices on Diagnosis, Prevention and Treatment of Post
    children Article Current Practices on Diagnosis, Prevention and Treatment of Post-Transplant Lymphoproliferative Disorder in Pediatric Patients after Solid Organ Transplantation: Results of ERN TransplantChild Healthcare Working Group Survey Alastair Baker 1, Esteban Frauca Remacha 2, Juan Torres Canizales 3 , Luz Yadira Bravo-Gallego 3,* , Emer Fitzpatrick 1, Angel Alonso Melgar 4, Gema Muñoz Bartolo 2, Luis Garcia Guereta 5, Esther Ramos Boluda 6 , Yasmina Mozo 7 , Dorota Broniszczak 8, Wioletta Jarmuzek˙ 9, Piotr Kalicinski 8 , Britta Maecker-Kolhoff 10, Julia Carlens 11, Ulrich Baumann 12, Charlotte Roy 13 , Christophe Chardot 14 , Elisa Benetti 15, Mara Cananzi 16, Elisabetta Calore 17, Luca Dello Strologo 18 , Manila Candusso 19, Maria Francelina Lopes 20 , Manuel João Brito 21, Cristina Gonçalves 22, Carmen Do Carmo 23, Xavier Stephenne 24, Lars Wennberg 25, Rosário Stone 26, Jelena Rascon 27 , Caroline Lindemans 28, Dominik Turkiewicz 29, Eugenia Giraldi 30, Emanuele Nicastro 31 , Lorenzo D’Antiga 31, Oanez Ackermann 32 and Paloma Jara Vega 2,33,† on behalf of ERN TransplantChild Healthcare Working Group 1 Paediatric Liver, Gastrointestinal and Nutrition Centre, School of Medicine, King’s College Hospital, King’s College London, Denmark Hill, London SE5 9RS, UK; [email protected] (A.B.); Citation: Baker, A.; Frauca Remacha, emer.fi[email protected] (E.F.) 2 E.; Torres Canizales, J.; Bravo-Gallego, Servicio de Hepatología Pediátrica, Hospital Universitario La Paz, 28046 Madrid, Spain; L.Y.; Fitzpatrick, E.; Alonso Melgar, [email protected] (E.F.R.); [email protected] (G.M.B.); A.; Muñoz Bartolo, G.; Garcia [email protected] (P.J.V.) Guereta, L.; Ramos Boluda, E.; Mozo, 3 Lymphocyte Pathophysiology in Immunodeficiencies Group, La Paz Institute of Biomedical Y.; et al.
    [Show full text]
  • Not for Publication Or Presentation a G E N D a CIBMTR WORKING COMMITTEE for IMMUNOBIOLOGY Orlando, FL Thursday, February 20, 20
    Not for publication or presentation A G E N D A CIBMTR WORKING COMMITTEE FOR IMMUNOBIOLOGY Orlando, FL Thursday, February 20, 2020, 12:15 pm–3:00 pm Co-Chair: Katharine Hsu, MD, PhD; Memorial Sloan-Kettering Cancer Center Telephone: 646-888-2667; E-mail: [email protected] Co-Chair: Sophie Paczesny, MD, PhD; Indiana University Hospital Telephone: 317-278-5487; E-mail: [email protected] Co-Chair: Steven Marsh, BSc, PhD, ARCS; Anthony Nolan Research Institute Telephone: +44 20 7284 8321; E-mail: [email protected] Co-Scientific Dir: Stephanie Lee, MD, MPH, Fred Hutchinson Cancer Research Center Telephone: 206-667-6190; E-mail: [email protected] Co-Scientific Dir: Stephen Spellman, MBS, CIBMTR Immunobiology Research Telephone: 763-406-8334; E-mail: [email protected] Statistical Director: Tao Wang, PhD, CIBMTR Statistical Center Telephone: 414-955-4339; E-mail: [email protected] Statisticians: Michelle Kuxhausen, MS, CIBMTR Statistical Center Telephone: 763-406-8727; E-mail: [email protected] 1. Introduction 12:15pm a. Minutes and Overview Plan of Immunobiology Working Committee from TCT 2019 (Attachment 1) b. Newly appointed chair: Shahinaz Gadalla, MD, PhD; National Cancer Institute Telephone: 240-276-7254; E-mail: [email protected] 2. Published and submitted papers 12:25pm a. IB06-05b Role of HLA-B exon 1 in graft-versus-host disease after unrelated haemopoietic cell transplantation: A retrospective cohort study. Petersdorf EW, Carrington M, O'hUigin C, Bengtsson M, De Santis D, Dubois V, Gooley T, Horowitz M, Hsu K, Madrigal JA, Maiers MJ, Malkki M, McKallor C, Morishima Y, Oudshoorn M, Spellman SR, Villard J, Stevenson P.
    [Show full text]
  • Kidney Transplantation Versus Dialysis
    Kidney Transplantation versus Dialysis A study in the current issue of ckj shows: 5-year mortality risk of transplanted patients is about 47% lower than that of patients on the waiting list! October 30, 2017 The number of adults waiting for a kidney transplant is growing from year to year. The main aim of an Irish study [1], lately published in CKJ (“Clinical Kidney Journal”), the open-access journal of the ERA-EDTA, was to compare the survival of patients who received a kidney transplant with the survival of patients awaiting transplantation and non-listed dialysis patients. To determine and compare the mortality of these three groups of patients, an analysis of the National Renal Transplant Registry and the Beaumont Hospital Renal Database (Clinical Vision 3.4a Version 1.1.34.1, Clinical Computing, Cincinnati, OH, USA) was carried out from 1 January 2004 to 31 December 2013. Analysis of survival was from the time of initial inclusion in the transplant waiting list to the time of death. What were the results? During the first 12 weeks after transplantation, the adjusted relative risk of death among kidney transplant recipients was 1.7 – 1.9 times higher than the risk among patients on the transplant waiting list. However, the risk of death among kidney transplant recipients started to fall thereafter to values below those on the waiting list. The 5-year mortality risk was estimated to be 47% lower than that of patients on the waiting list (RR, 0.53; 95% CI, 0.37–0.77; P = 0.001). “Directly after transplantation the mortality risk is somewhat higher due to the risk of surgical complications, infections or rejections.
    [Show full text]
  • Novel Kidney Auto Transplantation Technique for Ischemia-Reperfusion Studies
    Technical Note Novel Kidney Auto Transplantation Technique for Ischemia-Reperfusion Studies Michael Olausson 1,2,* , Deepti Antony 2 , Galina Travnikova 2, Debashish Banerjee 2 and Goditha U. Premaratne 2 1 Department of Transplantation, Sahlgrenska Academy, University of Gothenburg University and the Sahlgrenska Transplant Institute at Sahlgrenska University Hospital, SE-41345 Göteborg, Sweden 2 Laboratory for Transplantation and Regenerative Medicine, Sahlgrenska Academy at Gothenburg University and the Sahlgrenska Transplant Institute at Sahlgrenska University Hospital, SE-41345 Göteborg, Sweden; [email protected] (D.A.); [email protected] (G.T.); [email protected] (D.B.); [email protected] (G.U.P.) * Correspondence: [email protected]; Tel.: +46-(0)31-3421000 Abstract: Large animal studies of long-term ischemia reperfusion are hampered by the use of immunosuppressive drugs to inhibit the influence of the allogeneic response. In small animals, this can be controlled by using inbred strains of the animal. For obvious reasons, this is not possible in large animals such as pigs. Since studies in pigs usually are the last step before first-in-man studies, this remains a problem trying to resemble a clinical situation. In the following short paper, we describe a novel auto kidney transplantation model that can be used for long term ischemia reperfusion studies. We also suggest a control setting to balance out the possible influence of an increased surgical trauma. Citation: Olausson, M.; Antony, D.; Travnikova, G.; Banerjee, D.; Keywords: kidney transplantation; ischemia reperfusion studies; pig model; auto transplantation Premaratne, G.U. Novel Kidney Auto Transplantation Technique for Ischemia-Reperfusion Studies.
    [Show full text]
  • Orthotopic Kidney Auto-Transplantation in a Porcine Model Using 24 Hours Organ Preservation and Continuous Telemetry
    Orthotopic Kidney Auto-Transplantation in a Porcine Model Using 24 Hours Organ Preservation And Continuous Telemetry Wen-Jia Liu*,1,2, Lisa Ernst*,2, Benedict Doorschodt2, Jan Bednarsch1, Felix Becker3, Richi Nakatake2, Yuki Masano2, Ulf Peter Neumann1,4, Sven Arke Lang1, Peter Boor5, Isabella Lurje6, Georg Lurje1,6, René Tolba2, Zoltan Czigany1,2 1 Department of Surgery and Transplantation, Faculty of Medicine, University Hospital RWTH Aachen 2 Institute for Laboratory Animal Science, Faculty of Medicine, University Hospital RWTH Aachen 3 Department of General-, Visceral-, and Transplantation Surgery, University Hospital Muenster 4 Department of Surgery, Maastricht University Medical Centre (MUMC) 5 Institute of Pathology, Faculty of Medicine, University Hospital RWTH Aachen 6 Department of Surgery, Campus Charité Mitte | Campus Virchow-Klinikum, Charité-Universitätsmedizin * These authors contributed equally Corresponding Author Abstract Zoltan Czigany [email protected] In the present era of organ transplantation with critical organ shortage, various strategies are employed to expand the pool of available allografts for kidney Citation transplantation (KT). Even though, the use of allografts from extended criteria donors Liu, W.J., Ernst, L., Doorschodt, B., (ECD) could partially ease the shortage of organ donors, ECD organs carry a Bednarsch, J., Becker, F., Nakatake, R., Masano, Y., Neumann, U.P., Lang, S.A., potentially higher risk for inferior outcomes and postoperative complications. Dynamic Boor, P., Lurje, I., Lurje, G., Tolba, R., organ preservation techniques, modulation of ischemia-reperfusion and preservation Czigany, Z. Orthotopic Kidney Auto- Transplantation in a Porcine Model injury, and allograft therapies are in the spotlight of scientific interest in an effort to Using 24 Hours Organ Preservation And improve allograft utilization and patient outcomes in KT.
    [Show full text]
  • Colorectal Cancer After Kidney Transplantation: a Screening Colonoscopy Case-Control Study
    biomedicines Article Colorectal Cancer after Kidney Transplantation: A Screening Colonoscopy Case-Control Study Francesca Privitera 1, Rossella Gioco 1 , Alba Ilari Civit 1, Daniela Corona 2, Simone Cremona 1, Lidia Puzzo 3, Salvatore Costa 1, Giuseppe Trama 4, Flavia Mauceri 5, Aurelio Cardella 5, Giuseppe Sangiorgio 6, Riccardo Nania 6, Pierfrancesco Veroux 7 and Massimiliano Veroux 1,7,* 1 General Surgery, University Hospital of Catania, 95123 Catania, Italy; [email protected] (F.P.); [email protected] (R.G.); [email protected] (A.I.C.); [email protected] (S.C.); [email protected] (S.C.) 2 Department of Biomedical and Biotechnological Sciences, University of Catania, 95123 Catania, Italy; [email protected] 3 Pathology Unit, Department of Medical and Surgical Sciences and Advanced Technologies, University of Catania, 95123 Catania, Italy; [email protected] 4 Gastroenterology Unit, University Hospital of Catania, 95123 Catania, Italy; [email protected] 5 Faculty of Medicine, University of Catania, 95123 Catania, Italy; maucerifl[email protected] (F.M.); [email protected] (A.C.) 6 Department of General Surgery and Medical-Surgical Specialties, University of Catania, 95123 Catania, Italy; [email protected] (G.S.); [email protected] (R.N.) 7 Organ Transplant Unit, University Hospital of Catania Department of Medical and Surgical Sciences and Advanced Technologies, 95123 Catania, Italy; [email protected] * Correspondence: [email protected] Citation: Privitera, F.; Gioco, R.; Civit, A.I.; Corona, D.; Cremona, S.; Abstract: The incidence of colorectal cancer in kidney transplant recipients has been previously Puzzo, L.; Costa, S.; Trama, G.; reported with conflicting results. In this study, we investigated if the incidence of colorectal ad- Mauceri, F.; Cardella, A.; et al.
    [Show full text]
  • Annual Report 2008 / Ed
    2008 EUR O TRANSPLANT INTER N A TIO N AL FOUN D A TION A n n u a l R e p o r t 2 0 0 8 63082 om 2005 29-06-2006 13:40 Pagina 1 2008 Edited by Arie Oosterlee and Axel Rahmel Eurotransplant Aims Eurotransplant mission statement Mission Service organization for transplant candidates through the collaborating transplant programs within the organization. Goals • To achieve an optimal use of available donor organs and tissues • To secure a transparent and objective selection system, based upon medical and ethical criteria • To assess the importance of factors which have the greatest influence on waiting list mortality and transplant results • To support donor procurement to increase the supply of donor organs and tissues • To further improve the results of transplantation through scientific research and to publish and present these results • Promotion, support and coordination of organ donation and transplantation in the broadest sense of terms CIP-GEGEVENS KONINKLIJKE BIBLIOTHEEK, DEN HAAG Annual Report/Eurotransplant International Foundation.–Leiden: Eurotransplant Foundation. -III., graf., tab. Published annually Annual report 2008 / ed. by Arie Oosterlee and Axel Rahmel ISBN-13: 978-90-71658-28-0 Keyword: Eurotransplant Foundation; annual reports. 2 Table of contents - Board of Eurotransplant International Foundation 5 - TRANSPLANT PROGRAMS AND THEIR DELEGATES IN 2008 6 - Renal programs 6 - Heart programs 7 - Lung programs 8 - Liver programs 9 - Pancreas (islet) programs 10 - Tissue typing laboratories 11 - Foreword 13 1. Report of the Board and the central office of 14 Stichting Eurotransplant International Foundation 1.1 General 14 1.2 Policy 17 1.3 Quality Assurance & Safety 19 1.4 Advisory Committees 20 1.5 Recommendations approved 23 2.
    [Show full text]
  • Safety of Kidney Transplantion for Lung Transplant Recipients with End-Stage Renal Failure
    Central JSM Renal Medicine Bringing Excellence in Open Access Review Article *Corresponding author Keith C. Meyer, Department of Medicine, University of Wisconsin School of Medicine and Public Health, Safety of Kidney Transplantion Section of Allergy, Pulmonary and Critical Care Medicine, USA, Tel: 608-263-6363; 608-263-3035; Fax: 608- 263-3104; Email: for Lung Transplant Recipients Submitted: 11 August 2016 Accepted: 03 October 2016 with End-Stage Renal Failure Published: 05 October 2016 Copyright 1 2 2 Theodore J. McMenomy , Mehgan Holland , Nilto C. de Oliveira , © 2016 Meyer et al. James D. Maloney2, Richard D. Cornwell1, and Keith C. Meyer1* OPEN ACCESS 1Department of Medicine, University of Wisconsin School of Medicine and Public Health, USA Keywords 2Department of Surgery, University of Wisconsin School of Medicine and Public Health, • Transplant USA • Kidney transplantation • Lung transplantation Abstract • Renal failure Lung transplant recipients may develop profound renal dysfunction due to Stage IV kidney disease following successful lung transplantation (LTX). A comprehensive medical record review was performed for all LTX recipients transplanted from 1988 to 2012 to identify patients who subsequently underwent renal transplantation (RTX) for end-stage renal insufficiency. Sixteen LTX recipients underwent subsequent RTX (6 males, 10 females) at an average of 8.3 years (median 8, range 3-15) following LTX. Forced expiratory volume in 1 second (FEV1) obtained 6-12 months following RTX declined by more than 10% versus stable pre-RTX FEV1 values in only 4 recipients, and no recipients experienced new onset of BOS post-RTX. We conclude that RTX should be considered for those LTX recipients who develop chronic, end-stage renal failure, and that RTXcan be performed safely in LTX recipients without significant impact on lung allograft function.
    [Show full text]