المؤلفون: Schmidt J; Department of Urology, Charité, Universitätsmedizin Berlin, Freie Universität Berlin and Humboldt- Universität Zu Berlin, Charitéplatz 1, 10117, Berlin, Germany., Peters R; Department of Urology, Charité, Universitätsmedizin Berlin, Freie Universität Berlin and Humboldt- Universität Zu Berlin, Charitéplatz 1, 10117, Berlin, Germany., Mang J; Department of Urology, Charité, Universitätsmedizin Berlin, Freie Universität Berlin and Humboldt- Universität Zu Berlin, Charitéplatz 1, 10117, Berlin, Germany., Ralla B; Department of Urology, Charité, Universitätsmedizin Berlin, Freie Universität Berlin and Humboldt- Universität Zu Berlin, Charitéplatz 1, 10117, Berlin, Germany., Moldovan DE; Department of Urology, Charité, Universitätsmedizin Berlin, Freie Universität Berlin and Humboldt- Universität Zu Berlin, Charitéplatz 1, 10117, Berlin, Germany., Dagnæs-Hansen J; Department of Urology, Copenhagen University Hospital, Copenhagen, Denmark., Liefeldt L; Department of Nephrology and Intensive Care, Charité, Universitätsmedizin Berlin, Freie Universität Berlin and Humboldt- Universität Zu Berlin, Charitéplatz 1, 10117, Berlin, Germany., Budde K; Department of Nephrology and Intensive Care, Charité, Universitätsmedizin Berlin, Freie Universität Berlin and Humboldt- Universität Zu Berlin, Charitéplatz 1, 10117, Berlin, Germany., Lerchbaumer M; Department of Radiology, Charité, Universitätsmedizin Berlin, Freie Universität Berlin and Humboldt- Universität Zu Berlin, Charitéplatz 1, 10117, Berlin, Germany., Friedersdorff F; Department of Urology, Charité, Universitätsmedizin Berlin, Freie Universität Berlin and Humboldt- Universität Zu Berlin, Charitéplatz 1, 10117, Berlin, Germany. frank.friedersdorff@charite.de.; Department of Urology, Evangelisches Krankenhaus Königin Elisabeth Herzberge, Berlin, Germany. frank.friedersdorff@charite.de.

المصدر: World journal of urology [World J Urol] 2024 Mar 15; Vol. 42 (1), pp. 161. Date of Electronic Publication: 2024 Mar 15.

نوع المنشور: Journal Article

بيانات الدورية: Publisher: Springer International Country of Publication: Germany NLM ID: 8307716 Publication Model: Electronic Cited Medium: Internet ISSN: 1433-8726 (Electronic) Linking ISSN: 07244983 NLM ISO Abbreviation: World J Urol Subsets: MEDLINE

مواضيع طبية MeSH: Kidney Transplantation*/adverse effects, Humans ; Renal Artery/surgery ; Living Donors ; Retrospective Studies ; Graft Survival ; Kidney/diagnostic imaging ; Kidney/surgery ; Kidney/blood supply ; Treatment Outcome

مستخلص: Purpose: Accurate surgical reconstruction of arterial vascular supply is a crucial part of living kidney transplantation (LDKT). The presence of multiple renal arteries (MRA) in grafts can be challenging. In the present study, we investigated the impact of ligation versus anastomosis of small accessory graft arteries on the perioperative outcome.
Methods: Clinical and radiological outcomes of 51 patients with MRA out of a total of 308 patients who underwent LDKT with MRA between 2011 and 2020 were stratified in two groups and analyzed. In group 1 (20 patients), ligation of accessory arteries (ARAs) and group 2 (31 patients) anastomosis of ARAs was performed.
Results: Significant differences were observed in the anastomosis-, surgery-, and warm ischemia time (WIT) in favor of group 1. Students t-test showed comparable serum creatinine levels of 2.33 (± 1.75) to 1.68 (± 0.83) mg/dL in group 1 and 2.63 (± 2.47) to 1.50 (± 0.41) mg/dL in group 2, were seen from 1 week to 1 year after transplant. No increased rates of Delayed graft function (DGF), primary transplant dysfunction and transplant rejection were seen, but graft loss and revision rates were slightly higher when the ARAs were ligated. Analysis of Doppler sonography revealed that segmental perfusion deficits tend to regenerate during the clinical course.
Conclusion: Ligation of smaller accessory renal arteries may not affect the outcome of living kidney transplantation, except for a minor increase in the reoperation rate. Segmental perfusion deficits of the graft seem to regenerate in most cases as seen in Doppler sonography.
(© 2024. The Author(s).)

المؤلفون: Mang J; Department of Urology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität Zu Berlin, and Berlin Institute of Health, Charitéplatz 1, 10117, Berlin, Germany., Haag J; Department of Urology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität Zu Berlin, and Berlin Institute of Health, Charitéplatz 1, 10117, Berlin, Germany., Liefeldt L; Department of Nephrology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität Zu Berlin, and Berlin Institute of Health, Berlin, Germany., Budde K; Department of Nephrology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität Zu Berlin, and Berlin Institute of Health, Berlin, Germany., Peters R; Department of Urology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität Zu Berlin, and Berlin Institute of Health, Charitéplatz 1, 10117, Berlin, Germany., Hofbauer SL; Department of Urology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität Zu Berlin, and Berlin Institute of Health, Charitéplatz 1, 10117, Berlin, Germany., Schulz M; Department of Urology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität Zu Berlin, and Berlin Institute of Health, Charitéplatz 1, 10117, Berlin, Germany., Weinberger S; Department of Urology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität Zu Berlin, and Berlin Institute of Health, Charitéplatz 1, 10117, Berlin, Germany., Dagnæs-Hansen J; Urologic Research Unit, Department of Urology, Copenhagen University Hospital, Copenhagen, Denmark., Maxeiner A; Department of Urology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität Zu Berlin, and Berlin Institute of Health, Charitéplatz 1, 10117, Berlin, Germany., Ralla B; Department of Urology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität Zu Berlin, and Berlin Institute of Health, Charitéplatz 1, 10117, Berlin, Germany., Friedersdorff F; Department of Urology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität Zu Berlin, and Berlin Institute of Health, Charitéplatz 1, 10117, Berlin, Germany. frank.friedersdorff@charite.de.; Department of Urology, Evangelisches Krankenhaus Königin Elisabeth Herzberge, Berlin, Germany. frank.friedersdorff@charite.de.

المصدر: World journal of urology [World J Urol] 2024 Mar 06; Vol. 42 (1), pp. 120. Date of Electronic Publication: 2024 Mar 06.

نوع المنشور: Journal Article

بيانات الدورية: Publisher: Springer International Country of Publication: Germany NLM ID: 8307716 Publication Model: Electronic Cited Medium: Internet ISSN: 1433-8726 (Electronic) Linking ISSN: 07244983 NLM ISO Abbreviation: World J Urol Subsets: MEDLINE

مواضيع طبية MeSH: Nephrectomy*/adverse effects , Kidney*, Humans ; Retrospective Studies ; Transplantation, Homologous ; Graft Survival

مستخلص: Purpose: Management of a failed kidney allograft, and the question whether it should be removed is a challenging task for clinicians. The reported risks for transplant nephrectomy (TN) vary, and there is no clear recommendation on indications or surgical approach that should be used. This study gives an overview of indications, compares surgical techniques, and identifies risk factors for higher morbidity.
Methods: Retrospective analysis was conducted on all transplant nephrectomies performed between 2005 and 2020 at Charité Hospital Berlin, Department of Urology. Patient demographics, laboratory parameters, graft survival data, indication for TN, and surgical complications were extracted from medical reports.
Results: A total of 195 TN were performed, with graft intolerance syndrome being the most common indication in 52 patients (26.7%), acute rejection in 36 (18.5%), acute infection in 30 (15.4%), and other reasons to stop immunosuppression in 26 patients (13.3%). Rare indications were vascular complications in 16 (8.2%) and malignancies in the allograft in six (3.1%) cases. Extracapsular surgical approach was significantly more often used in cases of vascular complications and earlier allograft removal, but there was no difference in complication rates between extra- and intracapsular approach. Acute infection was identified as an independent risk factor for a complication grade IIIb or higher according to Clavien-Dindo classification, with a HR of 12.3 (CI 2.2-67.7; p = 0.004).
Conclusion: Transplant nephrectomy should only be performed when there is a good indication, and non-elective surgery should be avoided, when possible, as it increases morbidity.
(© 2024. The Author(s).)

المؤلفون: Zeuschner P; Department of Urology and Pediatric Urology, Saarland University, Kirrberger Street 100, 66421, Homburg/Saar, Germany. Philip.zeuschner@uks.eu., Mihm J; Medical Department III: Renal and Hypertensive Diseases, Immunology and Dialysis, SHG Kliniken Völklingen, Richardstraße 5-9, 66333, Völklingen, Germany., Sester U; Medical Department III: Renal and Hypertensive Diseases, Immunology and Dialysis, SHG Kliniken Völklingen, Richardstraße 5-9, 66333, Völklingen, Germany., Stöckle M; Department of Urology and Pediatric Urology, Saarland University, Kirrberger Street 100, 66421, Homburg/Saar, Germany. michael.stoeckle@uks.eu., Friedersdorff F; Department of Urology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Charitéplatz 1, 10117, Berlin, Germany. frank.friedersdorff@charite.de., Budde K; Department of Nephrology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Charitéplatz 1, 10117, Berlin, Germany., Yakac A; Department of Urology, University Hospital Carl Gustav Carus, Technische Universität Dresden, Fetscherstraße 74, 01307, Dresden, Germany., Thomas C; Department of Urology, University Hospital Carl Gustav Carus, Technische Universität Dresden, Fetscherstraße 74, 01307, Dresden, Germany., Huber J; Department of Urology, Philipps University of Marburg, Baldingerstraße, 35043, Marburg, Germany., Putz J; Department of Urology, University Hospital Carl Gustav Carus, Technische Universität Dresden, Fetscherstraße 74, 01307, Dresden, Germany., Flegar L; Department of Urology, Philipps University of Marburg, Baldingerstraße, 35043, Marburg, Germany.

المصدر: World journal of urology [World J Urol] 2024 Feb 16; Vol. 42 (1), pp. 85. Date of Electronic Publication: 2024 Feb 16.

نوع المنشور: Journal Article

بيانات الدورية: Publisher: Springer International Country of Publication: Germany NLM ID: 8307716 Publication Model: Electronic Cited Medium: Internet ISSN: 1433-8726 (Electronic) Linking ISSN: 07244983 NLM ISO Abbreviation: World J Urol Subsets: MEDLINE

مواضيع طبية MeSH: Kidney Transplantation*, Humans ; Retrospective Studies ; Waiting Lists ; Tissue Donors ; Graft Survival

مستخلص: Purpose: The Eurotransplant Senior program allocating grafts from donors ≥ 65 years to recipients aged ≥ 65 years has proven good results within the last 20 years. However, "old" grafts are also allocated to younger recipients < 65 years, and this outcome of "old for young" kidney transplantations (KT) still lacks detailed investigations.
Methods: All "old for young" KT performed at four tertiary referral centers were retrospectively compared including a recent follow-up, stratifying for "old for young" (donor ≥ 65 years to recipient < 65 years) vs. "very old for young" KT (donor ≥ 70 years to recipient < 65 years).
Results: Overall, 99 patients were included with 56 (56.6%) "old for young" and 43 (43.4%) "very old for young" KT. The median waiting time did not differ (60.7 vs. 45.8 months, respectively) at comparable living donation rates (57.1% vs. 44.2%) as well as intra- and postoperative results. At a median follow-up of 44 months (range 1; 133), the 3-year graft survival of 91% vs. 87% did not significantly vary. In subgroup analyses assessing living donation or donation after brain death (DBD) KT only, the graft survival was significantly longer for "old for young" KT within the living donation subgroup. In multivariate Cox regression analyses, the presence of panel-reactive antibodies was the only significant impact factor on graft survival (HR 8.32, p = 0.001).
Conclusion: This analysis clearly demonstrates the effectiveness of the "old for young" approach, enabling favorable perioperative results as well as comparable data of graft- and overall survival, while reducing waiting time for eligible patients.
(© 2024. The Author(s).)

المؤلفون: Mesnard B; Department of Urology, Nantes Université, CHU Nantes, Nantes, France., Territo A; Uro-Oncology and Kidney Transplant Unit, Department of Urology at 'Fundació Puigvert' Hospital, Autonoma University of Barcelona, Barcelona, Spain., Campi R; Department of Urology, Florence University Hospital, Florence, Italy., Hevia V; Department of Urology, University Hospital Ramón y Cajal, Madrid, Spain., Andras I; Department of Urology, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania., Piana A; Department of Urology, San Luigi Gonzaga Hospital, University of Turin, Orbassano, Turin, Italy., Pecoraro A; Department of Urology, Florence University Hospital, Florence, Italy., Boissier R; Department of Urology, La Conception University Hospital, Marseille, France., Prudhomme T; Department of Urology and Kidney Transplantation, Toulouse University Hospital, TSA 50032 Rangueil Hospital, 31059, Toulouse Cedex 9, France. prudhomme.t@chu-toulouse.fr.

مؤلفون مشاركون: EAU-Young Academic Urologist (YAU) group of Kidney Transplantation

المصدر: World journal of urology [World J Urol] 2023 Mar; Vol. 41 (3), pp. 695-707. Date of Electronic Publication: 2023 Mar 13.

نوع المنشور: Systematic Review; Journal Article

بيانات الدورية: Publisher: Springer International Country of Publication: Germany NLM ID: 8307716 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1433-8726 (Electronic) Linking ISSN: 07244983 NLM ISO Abbreviation: World J Urol Subsets: MEDLINE

مواضيع طبية MeSH: Kidney Transplantation*, Humans ; Female ; Aged ; Aged, 80 and over ; Delayed Graft Function ; Tissue Donors ; Kidney ; Graft Survival ; Age Factors

مستخلص: Purpose: The incidence of kidney transplants from elderly donors over 70 years of age has increased significantly over the past 10 years to reach 20% of available kidney graft in some European countries. However, there is little data available on the outcomes of transplants from these donors. We performed a systematic review to evaluate the outcomes of transplantation from donors over 70 years of age.
Methods: A systematic review was performed according to preferred reporting items for systematic reviews and meta-analyses. Medline, Embase, and Cochrane databases were searched to identify all studies reporting outcomes on kidney transplants from donors over 70 years. Due to the heterogeneity of the studies, a meta-analysis could not be performed.
Results: A total of 29,765 patients in 27 studies were included. The mean donors age was 74.79 years, and proportion of kidney graft from women was 53.54%. The estimated 1- and 5-year kidney death-censored graft survivals from donors > 70 years old were, respectively, 85.95 and 80.27%, and the patient survivals were 90.88 and 71.29%. The occurrence of delayed graft function was 41.75%, and primary non-function was 4.67%. Estimated graft function at 1 and 5 years was 36 and 38 mL/min/1.73 m ² . Paucity data were available on post-operative complications.
Conclusions: Elderly donors appear to be a reliable source of grafts. However, these transplants are associated with a high rate of delayed graft function without repercussion on long-term graft survival. Allocation strategy to elderly recipients is the main factor of decreased recipient survival.
(© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

المؤلفون: Pein U; Department of Nephrology, University Hospital Halle (Saale), Ernst-Grube-Str. 40, 06120, Halle (Saale), Germany. ulrich.pein@uk-halle.de., Girndt M; Department of Nephrology, University Hospital Halle (Saale), Ernst-Grube-Str. 40, 06120, Halle (Saale), Germany., Markau S; Department of Nephrology, University Hospital Halle (Saale), Ernst-Grube-Str. 40, 06120, Halle (Saale), Germany., Fritz A; Department of Nephrology, University Hospital Halle (Saale), Ernst-Grube-Str. 40, 06120, Halle (Saale), Germany., Breda A; Department of Urology, Autonoma University of Barcelona, Barcelona, Spain., Stöckle M; Department of Urology, University Hospital Saarland, Homburg/Saar, Germany., Mohammed N; Department of Urology, University Hospital Halle (Saale), Halle (Saale), Germany., Kawan F; Department of Urology, University Hospital Halle (Saale), Halle (Saale), Germany., Schumann A; Department of Urology, University Hospital Halle (Saale), Halle (Saale), Germany., Fornara P; Department of Urology, University Hospital Halle (Saale), Halle (Saale), Germany., Weigand K; Department of Urology, University Hospital Halle (Saale), Halle (Saale), Germany.

المصدر: World journal of urology [World J Urol] 2020 Mar; Vol. 38 (3), pp. 795-802. Date of Electronic Publication: 2019 May 24.

نوع المنشور: Comparative Study; Journal Article

بيانات الدورية: Publisher: Springer International Country of Publication: Germany NLM ID: 8307716 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1433-8726 (Electronic) Linking ISSN: 07244983 NLM ISO Abbreviation: World J Urol Subsets: MEDLINE

مواضيع طبية MeSH: Graft Survival* , Living Donors*, Kidney Transplantation/*methods , Nephrectomy/*methods , Robotic Surgical Procedures/*methods, Adult ; Aged ; Cohort Studies ; Female ; Humans ; Length of Stay ; Male ; Middle Aged ; Operative Time ; Postoperative Complications/epidemiology

مستخلص: Purpose: First robotic-assisted kidney transplants (RAKT) were performed in Germany in 2016. To introduce and establish this method as a routine procedure for patients in transplantation medicine, our 2-year experiences are presented.
Methods: Non-randomized open-label cohort study to compare functional and operative results as well as complication rates between RAKT and standard open transplantation. Collected data are part of ERUS RAKT Group Registry.
Results: Since initiation of the RAKT program 21/27 transplantations after living kidney donations have been performed as RAKT. This represents the largest series of RAKT in Germany. Patient survival, transplant survival, and primary function rate are 100% (mean follow-up 12.9 ± 8.6 month). Mean incision to closure time was 306.1 ± 45.5, mean handling time 70.8 ± 13.1 min compared to 212.1 ± 40.6 min and 51.7 ± 9.9 min, respectively, in the standard group. Despite extended operating times using the robotic approach, comparable complication rates and graft function with significant reduction in median length of hospital stay (14 vs. 20 days) were observed.
Conclusions: RAKT extends the options for recipients towards minimally invasive techniques. Compared to classic open surgery, RAKT appears to be safe in selected patients without influencing graft outcome or higher complication rates. However, RAKT till today is not suitable for all patients but seems to be one of the upcoming new standard techniques in kidney transplantation.

المؤلفون: Loubersac T; Urology, University Hospital of Nantes, Nantes, France. tloubersac@chu-nantes.fr.; Pediatric Urology Unit, University Hospital of Nantes, 1 place Alexis Ricordeau, Nantes, France. tloubersac@chu-nantes.fr., Roussey G; Pediatric Nephrology, University Hospital of Nantes, Nantes, France., Dengu F; Nuffield Department of Surgical Sciences, University of Oxford, Oxford, UK., Langlois d'Estaintot H; Pediatric Nephrology, University Hospital of Nantes, Nantes, France., Pere M; Biostatistics Unit, University Hospital of Nantes, Nantes, France., Glémain P; Urology, University Hospital of Nantes, Nantes, France., Rigaud J; Urology, University Hospital of Nantes, Nantes, France., Leclair MD; Pediatric Urology Unit, University Hospital of Nantes, 1 place Alexis Ricordeau, Nantes, France., Karam G; Urology, University Hospital of Nantes, Nantes, France., Branchereau J; Urology, University Hospital of Nantes, Nantes, France.; Nuffield Department of Surgical Sciences, University of Oxford, Oxford, UK.; Centre de Recherche en Transplantation Et Immunologie, UMR1064, INSERM, Université de Nantes, Nantes, France.

المصدر: World journal of urology [World J Urol] 2021 Jul; Vol. 39 (7), pp. 2789-2794. Date of Electronic Publication: 2021 Jan 03.

نوع المنشور: Comparative Study; Journal Article

بيانات الدورية: Publisher: Springer International Country of Publication: Germany NLM ID: 8307716 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1433-8726 (Electronic) Linking ISSN: 07244983 NLM ISO Abbreviation: World J Urol Subsets: MEDLINE

مواضيع طبية MeSH: Body Weight* , Kidney Transplantation*, Kidney Failure, Chronic/*surgery, Adolescent ; Child ; Child, Preschool ; Graft Survival ; Humans ; Infant ; Retrospective Studies ; Risk Factors ; Treatment Outcome

مستخلص: Background: The renal transplantation is the best treatment for end-stage renal disease in children. We present the findings of an analysis of our institution's paediatric transplant outcomes comparing recipients under 15 kg, who represent this potentially higher risk group, to those above 15 kg.
Methods: We retrospectively identified consecutive paediatric kidney transplants from a prospectively collected database for analysis. We included all recipients under the age of 18 years at the time of transplant between 2006 and 2018 without any exclusion criteria. The primary outcome was death-censored graft survival at 1 year, 5 years and 10 years.
Results: 109 paediatric kidney transplants were performed in 100 children. Graft survival in the all population was 98%, 96% and 76% at 1 year, 5 years and 10 years, respectively. Recipient weight below 15 kg was not found to be a risk factor of graft loss. Overall, we found no individual factor to be statistically significantly associated with renal graft lost. The overall complication rate was 16% (18/109) with 12 early complications (11%) and 6 late ones (5%).
Conclusion: Kidney transplantation in children weighing < 15 kg seems safe and offers the same patient and graft survival outcomes as in other (> 15 kg) pediatric recipients with equally low complication rates.
(© 2021. Springer-Verlag GmbH Germany, part of Springer Nature.)

المؤلفون: Vavallo A; Urology, Andrology and Kidney Transplantation Unit, Department of Emergency and Organ Transplantation (DETO), University of Bari, Piazza G. Cesare 11, 70124, Bari, Italy., Lucarelli G, Spilotros M, Bettocchi C, Palazzo S, Selvaggi FP, Battaglia M, Ditonno P

المصدر: World journal of urology [World J Urol] 2014 Jun; Vol. 32 (3), pp. 709-14. Date of Electronic Publication: 2013 Aug 02.

نوع المنشور: Journal Article

بيانات الدورية: Publisher: Springer International Country of Publication: Germany NLM ID: 8307716 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1433-8726 (Electronic) Linking ISSN: 07244983 NLM ISO Abbreviation: World J Urol Subsets: MEDLINE

مواضيع طبية MeSH: Graft Survival* , Kidney Transplantation* , Tissue Donors*, Graft Rejection/*epidemiology , Risk Assessment/*methods, Age Distribution ; Age Factors ; Female ; Follow-Up Studies ; Graft Rejection/prevention & control ; Humans ; Immunosuppressive Agents/therapeutic use ; Incidence ; Italy/epidemiology ; Male ; Middle Aged ; Prognosis ; Retrospective Studies ; Survival Rate/trends ; Time Factors

مستخلص: Purpose: Donor and recipient gender influence on post-transplant kidney and patient survival is still controversial, and the literature data do not present unanimous conclusions. The aim of this study was to evaluate the effect of gender disparities between donor and recipient in 963 kidney transplants performed at our center from January 2000 to December 2010.
Methods: The patients were subdivided into four groups according to recipient and donor gender: male donor-to-male recipient (MDMR; n = 305), male donor-to-female recipient (MDFR; n = 203), female donor-to-female recipient (FDFR; n = 206), and female donor-to-male recipient (FDMR; n = 249). Independent sample's t test and one-way ANOVA were used for statistical analyses. Graft and patient survival were calculated by the Kaplan-Meier method and compared using the log rank test.
Results: There were no statistically significant differences between the groups with regard to age, cold ischemia time, delayed graft function, primary non-function, and episodes of acute and chronic rejection. Moreover, no difference in either graft (p = 0.92) or patient (p = 0.41) survival at 1, 3, and 5 years was observed. However, female recipients had significantly lower serum creatinine values and higher estimated GFR, particularly if they received a male donor kidney, and these findings were stable up to 3-year post-transplantation.
Conclusions: No impact of gender on short- or long-term graft and patient survival was observed in deceased kidney transplantation. However, we report a lower creatinine level in the male donors to female recipients group as compared with other recipient-donor gender combinations, although this difference loses statistical significance after the third-year post-transplantation.

المؤلفون: Ness D; Guy's and St Thomas' NHS Foundation Trust, Renal Offices Borough Wing, Guy's Hospital, Great Maze Pond, London, SE1 9RT, UK. Daniel.Ness@gstt.nhs.uk., Olsburgh J; Guy's and St Thomas' NHS Foundation Trust, Renal Offices Borough Wing, Guy's Hospital, Great Maze Pond, London, SE1 9RT, UK.

المصدر: World journal of urology [World J Urol] 2020 Jan; Vol. 38 (1), pp. 81-88. Date of Electronic Publication: 2019 Apr 01.

نوع المنشور: Journal Article; Review

بيانات الدورية: Publisher: Springer International Country of Publication: Germany NLM ID: 8307716 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1433-8726 (Electronic) Linking ISSN: 07244983 NLM ISO Abbreviation: World J Urol Subsets: MEDLINE

مواضيع طبية MeSH: Anti-Bacterial Agents/*therapeutic use , Graft Rejection/*epidemiology , Immunosuppression Therapy/*methods , Kidney Transplantation/*adverse effects , Urinary Tract Infections/*epidemiology, Global Health ; Graft Rejection/prevention & control ; Graft Survival ; Humans ; Incidence ; Urinary Tract Infections/prevention & control

مستخلص: Urinary tract infection (UTI) remains the most common type of infection contracted by kidney transplant patients. UTI reduces both patient and graft survival. Understanding and managing UTI in transplant patients requires an appreciation of their unique anatomy and physiology. Both the transplant and native urinary systems can be affected by upper and/or lower urinary tract infections. Factors that contribute to UTI in kidney transplant patients are numerous and interact with each other. Factors can include excessive immunosuppression by medications and/or chronic disease, foreign material in the urinary system, transplant kidneys affected by ischaemia-reperfusion injury, non-functioning native kidneys, and abnormal lower urinary tracts. Research is ongoing to highlight the roles each of these contributing factors play and how they may be mitigated to reduce the incidence of UTI. Antimicrobials remain the mainstays of treatment and prophylaxis and this has promoted the development of multi-drug resistant organisms. This challenge necessitates awareness of UTI and methods to reduce rates by all healthcare professionals involved in kidney transplantation.

المؤلفون: Pichler R; Department of Urology, Medical University of Innsbruck, Anichstreet 35, 6020, Innsbruck, Austria. Renate.Pichler@i-med.ac.at, Klima G, Richter E, Marksteiner R, Mayr V, Skradski V, Horninger W, Oswald J

المصدر: World journal of urology [World J Urol] 2013 Feb; Vol. 31 (1), pp. 169-74. Date of Electronic Publication: 2012 Aug 04.

نوع المنشور: Journal Article

بيانات الدورية: Publisher: Springer International Country of Publication: Germany NLM ID: 8307716 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1433-8726 (Electronic) Linking ISSN: 07244983 NLM ISO Abbreviation: World J Urol Subsets: MEDLINE

مواضيع طبية MeSH: Graft Survival*, Fibroblasts/*transplantation , Vesico-Ureteral Reflux/*therapy, Animals ; Cell Survival ; Models, Animal ; Swine ; Tissue Engineering/methods ; Transplantation, Autologous

مستخلص: Purpose: To evaluate the cellular survival of donor fibroblasts after transplantation at the vesico-ureteral junction (VUJ) and to analyse their potential for reconstructive cell replacement in an animal model as autologous fibroblasts have been used as soft tissue augmentation material for scared and damaged tissue.
Methods: Muscles biopsies were procured from the lower limb muscles of 4 pigs; cytoplasm of fibroblasts was labelled with nano-sized iron oxide particles. Six weeks after taking of the muscle biopsies, fibroblast transplantation was performed, 3 × 10(6) cells suspended in transplantation medium (in 1-ml syringes) were injected at the VUJ using the modified STING technique. Animals were killed 8 weeks later; seeded fibroblasts were identified using prussian blue staining protocol; histological evaluation and morphological analysis were performed by light microscopy (Mayer's haematoxylin-eosin staining); and bladders were scanned by MRI for visualization and localization of the iron-labelled donor cells.
Results: Donor fibroblast cell colonization and cellular viability at the VUJ was demonstrated by MRI and histochemically indicating cellular uptake of iron particles at the VUJ. It was also evident that transplanted fibroblasts integrate into the extracellular matrix of the distal ureter augmenting ureteral host tissue.
Conclusions: Labelled implanted autologous fibroblasts were visualized by staining procedure as well as MRI scan demonstrating persistence at the VUJ, suggesting that in vitro expanded fibroblasts survived in vivo after transplantation.

المؤلفون: Barba J; Department of Urology, University of Navarra Clinic, P.O. Box 4209, 31008, Pamplona, Spain. jfbarba@unav.es, Rioja J, Robles JE, Rincón A, Rosell D, Zudaire JJ, Berian JM, Pascual I, Benito A, Errasti P

المصدر: World journal of urology [World J Urol] 2011 Aug; Vol. 29 (4), pp. 547-53. Date of Electronic Publication: 2011 Mar 09.

نوع المنشور: Evaluation Study; Journal Article

بيانات الدورية: Publisher: Springer International Country of Publication: Germany NLM ID: 8307716 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1433-8726 (Electronic) Linking ISSN: 07244983 NLM ISO Abbreviation: World J Urol Subsets: MEDLINE

مواضيع طبية MeSH: Graft Survival*, Kidney/*diagnostic imaging , Kidney Transplantation/*diagnostic imaging , Ultrasonography, Doppler/*methods, Adult ; Female ; Follow-Up Studies ; Humans ; Kaplan-Meier Estimate ; Male ; Middle Aged ; Postoperative Period ; Predictive Value of Tests ; Proportional Hazards Models ; Retrospective Studies ; Time Factors

مستخلص: Purpose: Renal Doppler ultrasonography (DUS) is the gold-standard image test for follow-up after renal transplantation, it is potentially useful to detect renal disease and it could be related with long-term survival. We evaluate whether renal graft survival can be predicted by immediate renal Doppler ultrasonography (IRDUS), defined as ultrasonography carried out in the first 24 h post-surgery.
Materials and Methods: Immediate renal DUS findings (resistance index, hydronephrosis, fluid collection, bruises, and vascularization abnormalities) and their association with graft survival were analyzed in a retrospective observational study of 343 renal allografts. Renal transplantation was done using a standard technique, and DUS was performed 24 h post-transplantation. The association of variables with graft survival was evaluated by Cox univariate and multivariate proportional hazards analysis. Kaplan-Meier survival analysis and the log-rank test were used to examine graft survival.
Results: The follow-up median was 85 months. On IRDUS, 137 patients (39.9%) had abnormal findings. The best RI cutpoint for the prediction of graft survival was 0.7; therefore, we defined two different groups: RI ≤ 0.7 (n = 247) versus RI > 0.7 (n = 96). Univariate analysis revealed that graft survival was significantly lower in patients with RI > 0.7 (P ≤ 0.001), vascularization abnormalities (P ≤ 0.001) or bruises (P = 0.026). In multivariate analysis, the only factors independently associated with graft survival were RI (odds ratio 2.4; 95% CI 1.4-4.1) and vascularization abnormalities (odds ratio 2.7; 95% CI 1.1-6.5).
Conclusions: IRDUS can be useful, besides being highly useful in the diagnosis of graft primary dysfunction in the transplanted patient also yields information that can help to predict long-term graft survival.