Your browser doesn't support javascript.
loading
Show: 20 | 50 | 100
Results 1 - 5 de 5
Filter
1.
Transplant Proc ; 44(10): 2918-20, 2012 Dec.
Article in English | MEDLINE | ID: mdl-23194997

ABSTRACT

PURPOSE: To report a single center experience with elective surgical patients as living kidney donors. METHODS: We retrospectively analyzed a prospective database of 458 living kidney donors from September 2005 to May 2011. Fifteen (3.2%) of them were elective surgical patients simultaneously undergoing living donor nephrectomy. We reviewed age, gender, operative time, intraoperative blood transfusion, intra- and postoperative complications, as well as length of hospital stay. Recipients were evaluated for delayed graft function. Four hundred forty-three patients undergoing living donor nephrectomy alone composed the control group. RESULTS: Among the elective surgical patients group, the mean (range) operative time was 155 (90 to 310) minutes and mean (range) length of hospital stay was 3 (2 to 9) days. One (6.7%) recipient displayed delayed graft function. Among the regular living kidney donors group, the mean (range) operative time was 100 (70 to 150) minutes, mean (range) length of hospital stay was 3 (2 to 5) days, and delayed graft function was observed in 5.6% of recipients. Only operative time (P = .03) was significantly different between the groups. CONCLUSIONS: Elective surgical patients are potential donors who may be treated at the same time as the living donor nephrectomy.


Subject(s)
Adrenalectomy , Cholecystectomy , Herniorrhaphy , Kidney Transplantation/methods , Living Donors , Nephrectomy , Tissue and Organ Harvesting/methods , Adrenalectomy/adverse effects , Adult , Aged , Brazil , Chi-Square Distribution , Cholecystectomy/adverse effects , Delayed Graft Function/etiology , Elective Surgical Procedures , Female , Herniorrhaphy/adverse effects , Humans , Kidney Transplantation/adverse effects , Longevity , Male , Middle Aged , Nephrectomy/adverse effects , Retrospective Studies , Risk Factors , Time Factors , Tissue and Organ Harvesting/adverse effects , Treatment Outcome
2.
Transplant Proc ; 40(10): 3397-400, 2008 Dec.
Article in English | MEDLINE | ID: mdl-19100398

ABSTRACT

OBJECTIVE: There are no data to support the suggestion that samples removed from one segment of the transplanted kidney are representative of the whole graft. The aim of this study was to compare the histological differences between biopsies obtained from different portions of the renal allograft and their impact on treatment recommendations. PATIENTS AND METHODS: Two hundred percutaneous biopsies were performed on kidney allografts and samples were collected from the upper and lower poles (100 kidneys). All samples were randomized and blindly reviewed. We obtained the discordance rates between the poles for the grading of acute rejection and for the diagnosis of nephrotoxicity due to immunosuppression. We also checked if the differences found were sufficient to call for different clinical recommendations. These values were compared with the intrapathologist variation rates. RESULTS: In 70 kidneys adequate sampling was obtained from both poles. The diagnosis of acute rejection were made in 17. The discordance rate between the upper and lower poles was 82.3% (kappa = 0.34), higher than the intrapathologist variation (P = .002). Nephrotoxicity was found in 14 kidneys. The discordance rate between the upper and lower poles was 28.6% (kappa = 0.88), with no difference compared with the intrapathologist variation. In 14 of the 70 kidneys (25.7%), discordances between poles had impact on clinical recommendations, most of these cases due to different gradings of acute rejection (78%). This number was higher than the intrapathologist variation (P = .04). CONCLUSIONS: The histopathological changes in the kidney allograft are not always homogeneous. This heterogeneity may affect the therapeutic recommendations.


Subject(s)
Biopsy, Needle/methods , Graft Rejection/pathology , Kidney Transplantation/pathology , Adolescent , Adult , Automation , Blood Pressure , Graft Rejection/chemically induced , Humans , Immunosuppressive Agents/toxicity , Kidney Transplantation/physiology , Kidney Tubules/pathology , Necrosis , Observer Variation , Patient Selection , Random Allocation , Reproducibility of Results , Retrospective Studies , Transplantation, Homologous/pathology , Transplantation, Homologous/physiology
4.
Clin Transplant ; 15(6): 393-6, 2001 Dec.
Article in English | MEDLINE | ID: mdl-11737115

ABSTRACT

UNLABELLED: Biopsy is the gold standard for the diagnosis of conditions affecting the function of renal allografts. Obtaining representative tissue in biopsies is critical but these procedures are associated with up to 9% of complications and 20% of inadequate material. Although ultrasound guidance allows perfect control of depth and location of the graft, there is controversy regarding the cost-benefit of its use and reports of unsuitable material in ultrasound-guided biopsies are still high. PURPOSE: To compare ultrasound with the palpation method to guide biopsies in order to see if there is any difference between both methods and which one is better. PATIENTS AND METHODS: The casuistic consisted of 82 renal transplant patients (32 female and 50 male patients, age ranging between 5 and 64 yr; m=31.2 yr) randomized into two groups: GI, palpation-guided; GII, ultrasound-guided. Fifty-six biopsies were performed in GI and 66 in GII. RESULTS: Number of glomeruli, arcuate, and interlobar arteries and arterioles were compared in the two groups and were 503 (m=10) vs. 801 (m=12.9), 24 (m=0.5) vs. 38 (m=0.6), 104 (m=2.1) vs. 154 (m=2.5), and 174 (m=3.5) vs. 264 (4.3), respectively (p<0.05). Inadequate material for analysis in GI and GII was 7.1 and 7.6%, respectively (p=0.72). CONCLUSIONS: Although ultrasound guidance improves the number of glomeruli, arcuate, and interlobar arteries, as well as arterioles, compared with palpation-guided biopsies, there is no difference in the rate of adequate material between the two methods.


Subject(s)
Biopsy/methods , Kidney Transplantation , Kidney/diagnostic imaging , Kidney/pathology , Palpation , Adolescent , Adult , Child , Child, Preschool , Female , Humans , Male , Middle Aged , Postoperative Care , Transplantation, Homologous , Ultrasonography
SELECTION OF CITATIONS
SEARCH DETAIL