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2.
Curr Urol Rep ; 21(1): 1, 2020 Jan 18.
Artigo em Inglês | MEDLINE | ID: mdl-31960192

RESUMO

PURPOSE OF REVIEW: Kidney transplantation and gender affirmation treatments are becoming increasingly more prevalent due to advances in technology. However, there is a paucity of data regarding kidney transplantation in transgender patients. Interesting considerations must be made in this patient population, since there are many hormonal interactions with kidney function and the transplantation process. RECENT FINDINGS: The diagnosis of estimated glomerular filtration rate (eGFR), preoperative assessment/counseling, decreased testosterone levels in a transgender male to female patient, increased estrogen/progesterone in a female to male patient, and drug side effects all have important and unique implications for kidney transplant recipients. Kidney transplantation can be safely and effectively managed in transgender patients with special considerations in eGFR calculations, mental health/lifestyle counseling, and drug interactions.


Assuntos
Falência Renal Crônica/cirurgia , Transplante de Rim , Pessoas Transgênero , Taxa de Filtração Glomerular , Humanos , Falência Renal Crônica/fisiopatologia , Transexualismo/tratamento farmacológico , Transexualismo/metabolismo , Transexualismo/cirurgia
3.
J Urol ; 203(2): 406-412, 2020 02.
Artigo em Inglês | MEDLINE | ID: mdl-31487221

RESUMO

PURPOSE: We assessed renal function, graft survival rates and the risk of graft loss in children based on etiology with a focus on differences between urological causes from congenital anomalies of the kidney and urinary tract vs other causes of end stage kidney disease. MATERIALS AND METHODS: A retrospective chart review was performed including patients younger than 18 years who underwent kidney transplantation at our institution from December 1984 to November 2010 with the last followup recorded in March 2018. Patient clinical characteristics, demographics and end stage kidney disease etiology were recorded. Patients were divided into the 2 groups of urological (congenital anomalies of the kidney and urinary tract) vs nonurological based on end stage kidney disease etiology, and survival analysis was performed. RESULTS: Of 112 kidney transplant cases 90 (80.4%) were associated with nonurological causes and 22 (19.6%) with urological causes. Median (IQR) patient age at transplantation was 12 (7-15) years. Median graft survival time was not statistically different according to end stage kidney disease etiology (nonurological 12 years 95% CI 10.01-13.99 vs urological 16 years 95% CI 7.59-24.41, p=0.532). There was a significant risk of graft loss in patients with urinary tract infections after transplantation (HR 3.15, 95% CI 1.59-6.25, p=0.001). CONCLUSIONS: Children requiring transplantation due to urological causes have no disadvantage in graft survival compared to children with end stage kidney disease with other causes. Patients with urinary tract infection after transplantation had a higher rate of graft loss.


Assuntos
Falência Renal Crônica/cirurgia , Transplante de Rim , Sistema Urinário/anormalidades , Sistema Urinário/cirurgia , Adolescente , Criança , Feminino , Humanos , Masculino , Complicações Pós-Operatórias/epidemiologia , Estudos Retrospectivos , Fatores de Tempo , Resultado do Tratamento
4.
Urologe A ; 59(1): 27-31, 2020 Jan.
Artigo em Alemão | MEDLINE | ID: mdl-31858164

RESUMO

Renal transplantations in augmented bladders or urinary diversions are rare, accounting for only 1-2% of all renal transplantations. In most cases a dysfunctional lower urinary tract is the cause of end-stage renal disease in these patients; therefore recovery of the lower urinary tract is mandatory for long-term graft survival. Usually, urinary diversion is timed several months prior to renal transplantation. Beside renal transplantations into an ileum conduit, renal transplantations in continent urinary diversions have become increasingly popular. The most frequent complications are bacteriuria and urinary tract infections, which usually do not lead to graft loss when treated correctly with antibiotics. Long-term outcome of renal transplantations in urinary diversions is comparable to transplantations in healthy native bladders.


Assuntos
Falência Renal Crônica/cirurgia , Transplante de Rim , Neoplasias da Bexiga Urinária/cirurgia , Derivação Urinária , Cistectomia , Humanos , Falência Renal Crônica/etiologia , Derivação Urinária/efeitos adversos
5.
Clin Ter ; 170(6): e454-e459, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31696909

RESUMO

AIMS: The radio-cephalic arteriovenous fistula (RCAVF) is the first choice treatment in end-stage renal disease patients. In the last few years, the hemodialysis population has shown a high percentage of elderly patients (> 65 year old) with comorbidities, mainly vascular diseases, which may adversely affect their vascular access success. The aim of this study was to evaluate the effectiveness of a loup-assisted technique to create RCAVFs in over 65 patients. PATIENTS AND METHODS: 98 consecutive patients with renal failure were prospectively observed. The patient were divided in relation to their age (> 65 year old; < 65 year old). In both groups, a microsurgical distal RCAVF was created. Statistics included the prevalence of distal RCAVF created, the incidence of immediate failure, the primary and secondary patency rate at one year. RESULTS: Distal RCAVF was created in 82.60% of patients younger than 65 years and in 73.07% of patients older than 65 years, with no statistically significant difference. The incidence of immediate failure, the primary and secondary patency at one year were not statistically significant between the two groups. CONCLUSIONS: Distal RCAVF should be the first choice vascular access even in ESRD elderly patients. The loup-assisted microsurgical fistula creation, allows to perform distal RCAVF with success, even in patients older than 65 years old, achieving similar results to younger patients.


Assuntos
Derivação Arteriovenosa Cirúrgica/métodos , Idoso , Idoso de 80 Anos ou mais , Derivação Arteriovenosa Cirúrgica/efeitos adversos , Feminino , Humanos , Falência Renal Crônica/cirurgia , Falência Renal Crônica/terapia , Masculino , Pessoa de Meia-Idade , Seleção de Pacientes , Diálise Renal , Resultado do Tratamento
6.
Rev Port Cir Cardiotorac Vasc ; 26(3): 209-212, 2019.
Artigo em Português | MEDLINE | ID: mdl-31734973

RESUMO

INTRODUCTION: True arterial aneurysms of the upper limb are rare and their treatment is intended to avoid complications as distal embolization, compression of surrounding neurovascular structures or rupture. OBJECTIVE: The purpose of this study is to review the experience of a department in the surgical treatment of true arterial aneurysms of the upper limb. METHODS: A retrospective study was performed between January 2007 and August 2017. RESULTS: From a total of eleven patients, nine were male and two were female. One of the patients had surgery twice because of two consecutive aneurysms of the upper limb. From a total of twelve cases, two were subclavian, one was axillary and nine were brachial aneurysms. Three of them had degenerative/idiopathic aetiology, one was associated to a cervical rib and seven occurred in the setting of arteriovenous fistula or kidney graft. Five patients had emergent surgery and the others had elective surgery. All of the patients were submitted to aneurysmectomy. As 30-day complications, there were two haematomas, one compartment syndrome and two early graft occlusions. Four patients needed re-intervention. During the follow-up period, all the grafts initially preserved were patent. There were no further known complications or amputation procedures. CONCLUSION: In this review most of the aneurysms were found in patients with haemodialysis vascular access or kidney grafts. Despite the need for early re-intervention in some cases, the surgical treatment of true arterial aneurysms of the upper limb is a low morbidity procedure.


Assuntos
Aneurisma/cirurgia , Falência Renal Crônica/terapia , Doença Arterial Periférica/cirurgia , Extremidade Superior/irrigação sanguínea , Aneurisma/complicações , Feminino , Humanos , Falência Renal Crônica/complicações , Falência Renal Crônica/cirurgia , Transplante de Rim , Masculino , Doença Arterial Periférica/complicações , Diálise Renal , Estudos Retrospectivos , Resultado do Tratamento , Extremidade Superior/cirurgia
8.
Transplant Proc ; 51(9): 2995-2997, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31607619

RESUMO

Incidence of malignant tumors in kidney transplant recipients is higher than nontransplanted population due to many factors, such as immunosuppression therapy and complex donor-recipient interaction. Genitourinary malignancies have been reported as the second most common malignancy in kidney transplant recipients. In this regard, prostate cancer is the most common neoplasm. Herein, we describe a rare case of prostate cancer recurrence after 15 years in a patient who underwent kidney transplant after radical prostatectomy.


Assuntos
Hospedeiro Imunocomprometido , Imunossupressão/efeitos adversos , Transplante de Rim/efeitos adversos , Recidiva Local de Neoplasia/imunologia , Neoplasias da Próstata/imunologia , Idoso , Humanos , Falência Renal Crônica/complicações , Falência Renal Crônica/cirurgia , Masculino , Prostatectomia , Neoplasias da Próstata/complicações
9.
Transplant Proc ; 51(9): 3080-3083, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31627919

RESUMO

As the field of transplant evolves and patients with chronic disease live longer, retransplant for end-stage renal disease becomes more common because kidney allografts have a limited lifespan. In renal retransplant, graft and patient survival is near equivalent to first-time transplant; however, these procedures present a unique surgical risk profile, especially third and subsequent transplants, which are reviewed in this manuscript. The risk of bowel obstruction in primary kidney transplant recipients is much lower than patients who have undergone laparotomy for second or third transplant because of the retroperitoneal location of the transplanted kidney. Internal hernia is an uncommon cause of small bowel obstruction, particularly after kidney transplant, and often diagnosis and intervention are delayed because of diagnostic uncertainty. We report a case of a 34-year-old man with acute kidney injury and bowel obstruction, whose final diagnosis was an internal hernia around the transplanted ureter of an intra-abdominally placed third renal transplant resulting in ureteric obstruction associated with small bowel obstruction-a case of double obstruction.


Assuntos
Obstrução Intestinal/etiologia , Transplante de Rim/efeitos adversos , Reoperação/efeitos adversos , Obstrução Ureteral/etiologia , Adulto , Humanos , Falência Renal Crônica/cirurgia , Masculino
10.
Transplant Proc ; 51(9): 3178-3180, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31619344

RESUMO

We describe a unique case of a 53-year-old woman who underwent a nonrelated living donor kidney transplant 9 years after a previous small bowel transplant from her sister. The patient had suffered from short bowel syndrome secondary to volvulus after undergoing bariatric surgery for morbid obesity. Her entire small bowel had to be resected emergently, but she also developed acute kidney failure at the time. This initial kidney injury associated with long-term exposure to calcineurin-inhibitor medication eventually led to end-stage renal disease. A successful kidney transplant from a different, nonrelated adult donor was performed. Of note, the unrelated kidney donor matched exactly the 2 HLA-A and HLA-B antigens that the recipient had not matched with her sister. We discuss the unique HLA configuration between the patient and her 2 living donors, the absence of posttransplant rejection and posttransplant immunosuppressive therapy. To our knowledge this is the first published report of a successful kidney after a previous bowel transplant using (2 different) living donors.


Assuntos
Intestino Delgado/transplante , Falência Renal Crônica/cirurgia , Transplante de Rim/métodos , Doadores Vivos , Cirurgia Bariátrica/efeitos adversos , Feminino , Rejeição de Enxerto , Sobrevivência de Enxerto , Humanos , Imunossupressão/métodos , Volvo Intestinal/etiologia , Volvo Intestinal/cirurgia , Falência Renal Crônica/complicações , Pessoa de Meia-Idade , Obesidade Mórbida/cirurgia , Síndrome do Intestino Curto/etiologia , Síndrome do Intestino Curto/cirurgia
11.
Medicine (Baltimore) ; 98(37): e17006, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31517819

RESUMO

CD200 is an immunoglobulin superfamily membrane protein that binds to a myeloid cell-specific receptor and induces inhibitory signaling. The aim of this study was to investigate the role of CD200 and its receptor (CD200R1) on kidney transplant (KTx) outcome. In a collective of 125 kidney recipients (University hospital, Heidelberg, Germany), CD200 and CD200R1 concentrations were evaluated immediately before transplantation. Recipient baseline and clinical characteristics and KTx outcome, including acute rejection (AR), acute tubular necrosis, delayed graft function, cytomegalovirus (CMV) and human polyomaviridae (BK) virus infections, and graft loss were evaluated during the first post-transplant year. The association of CD200 and CD200R1 concentrations and CD200R1/CD200 ratios with the outcome of KTx was investigated for the first time in a clinical setting in a prospective cohort. There was a positive association between pre-transplant CD200R1 concentrations and CMV (re)activation (P = .041). Also, increased CD200R1 concentration was associated with a longer duration of CMV infection (P = .049). Both the frequency of AR and levels of creatinine (3 and 6 months after KTx) were significantly higher in patients with an increased CD200R1/CD200 ratio (median: 126 vs 78, P = .008). Increased pre-transplant CD200R1/CD200 ratios predict immunocompetence and risk of AR, whereas high CD200R1 concentrations predict immunosuppression and high risk of severe CMV (re)activation after KTx.


Assuntos
Antígenos CD/sangue , Antígenos de Superfície/sangue , Falência Renal Crônica/sangue , Falência Renal Crônica/cirurgia , Transplante de Rim , Complicações Pós-Operatórias/diagnóstico , Receptores de Superfície Celular/sangue , Adulto , Idoso , Biomarcadores/sangue , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Período Pré-Operatório , Prognóstico , Estudos Prospectivos , Adulto Jovem
12.
Cir Cir ; 87(S1): 68-72, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31501627

RESUMO

Due the shortage of organ donors and the increase in the waiting list of kidney transplant recipients (KTR), alternative strategies have been considered with the aim of increasing the number of organs available. The use of kidneys from donors with acute renal failure and elevated serum creatinine has been considered as a way to increase the number of donors. The objective of this work is to report the 3-year follow-up of three KTR patients of a deceased donor with serum creatinine greater than or equal to 5 mg/dL.


Assuntos
Lesão Renal Aguda/sangue , Creatinina/sangue , Transplante de Rim , Doadores de Tecidos , Obtenção de Tecidos e Órgãos/normas , Adulto , Cadáver , Carcinoma de Células Renais/cirurgia , Nefropatias Diabéticas/complicações , Feminino , Seguimentos , Taxa de Filtração Glomerular , Sobrevivência de Enxerto , Humanos , Rim/fisiologia , Falência Renal Crônica/etiologia , Falência Renal Crônica/cirurgia , Neoplasias Renais/cirurgia , Masculino , Nefrectomia , Reoperação , Transplantes/fisiologia , Resultado do Tratamento , Refluxo Vesicoureteral/complicações , Adulto Jovem
13.
Transplant Proc ; 51(8): 2842-2844, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31526531

RESUMO

All over the world there is serious concern about the shortage of organs available for transplantation. In an effort to address this, transplantation with grafts, which was previously considered a contraindication, are now performed. In some cases, this practice has contributed to increasing the organ pool. Fibromuscular dysplasia (FMD) is the second-most-common cause of renovascular hypertension and is observed in 2%-6.6% of potential live kidney donors. Kidney with FMD is generally considered to be a contraindication for renal transplantation because renal artery stenosis may progress after transplantation and cause graft loss. Here, we report on a successful case of kidney transplantation using a graft with FMD of a deceased donor who had multiple aneurysms in the renal artery.


Assuntos
Displasia Fibromuscular , Falência Renal Crônica/cirurgia , Transplante de Rim , Adulto , Feminino , Humanos , Transplante de Rim/métodos , Resultado do Tratamento
14.
J Bras Nefrol ; 41(2): 185-192, 2019.
Artigo em Inglês, Português | MEDLINE | ID: mdl-31498862

RESUMO

BACKGROUND: Arteriovenous fistula (AVF) maturation is one of the main concerns in patients with end-stage renal disease (ESRD) and finding a strategy for increasing success rate and accelerating fistula maturation is valuable. The aim of this study was to evaluate the effects of papaverine injection on AVF maturation and success rate. METHOD: This study was a randomized clinical trial that involved 110 patients with ESRD that were referred for AVF construction. Patients were allocated in papaverine group and control group with block randomization according to age and sex. In the case group, papaverine (0.1 or 0.2 cc) was injected locally within the subadventitia of artery and vein after proximal and distal control during AVF construction and in the control group, AVF construction was done routinely without papaverine injection. RESULTS: Maturation time in case and control groups was 37.94 ± 11.49 and 44.23 ± 9.57 days, respectively (p=0.004). Hematoma was not seen in the case group but occurred in one patient in the control group. One patient of the case group developed venous hypertension. Four functional fistulas, 1 (1.8%) in the case group and 3 (5.5%) in the control group, failed to mature (p=0.618). Maturation rate did not differ between the two groups statistically (p=0.101). CONCLUSION: Local papaverine injection increased vessel diameter and blood flow, increasing shearing stress in both arterial and venous segment of recently created AVF. In this way, papaverine probably can decrease AVF maturation time without an increase in complications.


Assuntos
Derivação Arteriovenosa Cirúrgica/métodos , Falência Renal Crônica/cirurgia , Papaverina/farmacologia , Vasodilatadores/farmacologia , Adolescente , Adulto , Idoso , Derivação Arteriovenosa Cirúrgica/efeitos adversos , Feminino , Seguimentos , Hematoma/etiologia , Humanos , Masculino , Pessoa de Meia-Idade , Papaverina/administração & dosagem , Estudos Prospectivos , Diálise Renal , Trombose/etiologia , Resultado do Tratamento , Vasodilatadores/administração & dosagem , Pressão Venosa , Adulto Jovem
15.
Transplant Proc ; 51(8): 2549-2554, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31473007

RESUMO

INTRODUCTION: The prevalence of chronic kidney failure is significantly increasing in Vietnam, causing a burden for health care. This study assessed the relationship of HLA-A, -B, and -DRB1 alleles with end-stage renal disease (ESRD). METHOD: A retrospective, cross-sectional study and a comparative study using secondary data analysis were conducted on 196 ESRD patients and 187 controls from 2009 to 2017. The patient and donor profiles were collected from medical records, including age, sex, etiology of renal failure, and HLA phenotypes. HLA-A*, -B*, and -DRB1* typing were done by polymerase chain reaction-sequence specific primers. RESULT: The most frequent HLA alleles in Vietnamese patients with ESRD were HLA-A*02, -A*11, -B*15, -B*46, -DRB1*04, -DRB1*09, and -DRB1*12. The haplotypes HLA-A*0233 (odds ratio [OR] = 0.40, 95% CI: 0.15-0.98) had a negative association for ESRD. The haplotypes HLA-B*1515 (OR = 4.14, 95% CI: 1.52-11.26) and HLA-DRB1*1212 (OR = 2.01, 95% CI: 1.06-3.81) had a positive association for ESRD. The haplotypes HLA-B*1515 (OR = 4.69, 95% CI: 1.69-13.03) and -DRB1*1212 (OR = 2.15, 95% CI: 1.10-4.21) had a positive association for ESRD related to glomerulonephritis. The HLA-B*1557 (OR = 17.34, 95% CI: 2.70-11.49) had a positive association for ESRD related to hypertension. CONCLUSION: The haplotypes of HLA class I and II had significant relationships with ESRD. The results of our study should be confirmed in further investigations.


Assuntos
Haplótipos/genética , Antígenos de Histocompatibilidade Classe I/genética , Falência Renal Crônica/genética , Falência Renal Crônica/imunologia , Transplante de Rim , Adulto , Estudos Transversais , Feminino , Frequência do Gene , Glomerulonefrite/genética , Glomerulonefrite/imunologia , Humanos , Falência Renal Crônica/cirurgia , Masculino , Pessoa de Meia-Idade , Razão de Chances , Fenótipo , Período Pré-Operatório , Estudos Retrospectivos , Vietnã
16.
Transplant Proc ; 51(7): 2274-2278, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31474292

RESUMO

BACKGROUND: Retransplantation is a treatment option in patients with end-stage renal failure due to graft loss. Outcomes of these patients due to high immunologic risk remain unclear. The aim of this study was to evaluate outcomes of renal retransplantation patients retrospectively. METHODS: Renal retransplant patients in our unit were evaluated retrospectively between 2010 and 2018. Patients' demographic characteristics, primary diseases, the causes of prior graft loss, immunologic status, desensitization protocols, the induction and maintenance treatments, the complications during the follow-up period, numbers of acute rejections, and the clinical prognosis were all detected from the patients' files. RESULTS: We retrospectively evaluated 17 patients who underwent a second or third renal allograft. Of these, 16 received a second and the remaining 1 patient received a third renal allograft. Immunologically, all of the 17 patients had negative flow cytometry crossmatch, 1 patient had a positive complement-dependent cytotoxicity crossmatch (Auto 12%), 16 patients had positive panel reactive antibody, the median HLA-mismatch was 3.5, and the score of donor-specific antibody relative intensity score (RIS) was 6.4 ± 6.3. Ten pretransplant patients had desensitization treatment. While scores for HLA-MM and HLA-RIS in the patients who had a desensitization therapy were determined higher, no statistical difference was observed (respectively, P = .28 and .55). No acute rejection episode developed. BK virus DNA viremia was detected in 4 patients during the posttransplant 6th month. We observed no patient death or no graft loss during the follow-up period. CONCLUSION: Although the retransplant patients who had a graft loss previously have high immunologic risks, retransplantation is reliable in these patients, but they should be followed up carefully in terms of BKV nephropathy.


Assuntos
Dessensibilização Imunológica/estatística & dados numéricos , Rejeição de Enxerto/cirurgia , Falência Renal Crônica/cirurgia , Transplante de Rim/métodos , Reoperação/métodos , Adulto , Dessensibilização Imunológica/métodos , Feminino , Rejeição de Enxerto/imunologia , Sobrevivência de Enxerto/imunologia , Teste de Histocompatibilidade/métodos , Humanos , Rim/imunologia , Falência Renal Crônica/etiologia , Transplante de Rim/efeitos adversos , Masculino , Pessoa de Meia-Idade , Prognóstico , Estudos Retrospectivos , Transplante Homólogo , Resultado do Tratamento , Adulto Jovem
17.
Transplant Proc ; 51(9): 3171-3173, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31371217

RESUMO

Fabry's disease is a X-linked hereditary disease that causes the accumulation of glycosphingolipids in tissues and organs, including the kidneys and heart. This can result in both chronic kidney disease and cardiac dysfunction, including arrhythmias and heart failure. We describe a case of a 62-year-old male with Fabry's disease undergoing successful combined heart and kidney transplantation for chronic renal failure and low-output systolic heart failure. The patient has normal cardiac function and normal renal function 7 years after transplantation, while being maintained on enzyme replacement therapy with recombinant human alpha-galactosidase A. Fabry's disease is not a contraindication for organ transplantation, even in patients presenting with both renal failure and heart failure.


Assuntos
Doença de Fabry/complicações , Insuficiência Cardíaca/cirurgia , Transplante de Coração/métodos , Falência Renal Crônica/cirurgia , Transplante de Rim/métodos , Doença de Fabry/tratamento farmacológico , Insuficiência Cardíaca/genética , Humanos , Falência Renal Crônica/genética , Masculino , Pessoa de Meia-Idade , alfa-Galactosidase/uso terapêutico
18.
Transplant Proc ; 51(6): 1845-1847, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31399169

RESUMO

BACKGROUND: There are numerous reports of successful pregnancies following kidney transplantation. However, little information is available regarding the management and evolution of multiple pregnancies in a kidney-transplanted woman. CASE REPORT: We report the case of successful consecutive spontaneous triplet and twin pregnancies in a woman who had undergone kidney transplantation at 30 years of age, 12 years before the first pregnancy, as a result of end-stage renal disease secondary to chronic glomerulonephritis due to diffuse proliferative lupus nephritis. An integrated multidisciplinary team closely followed progress during the pregnancies. Maternal complications during the pregnancies included light proteinuria, controlled hypertension, and anemia. No graft rejection episodes or deterioration of renal function was noted during the pregnancies or after the deliveries. CONCLUSION: Currently, more than 2 years after her last pregnancy, the mother and all 5 babies are healthy and the mother's renal transplant function is normal.


Assuntos
Falência Renal Crônica/cirurgia , Transplante de Rim , Gravidez de Trigêmeos , Gravidez de Gêmeos , Adulto , Intervalo entre Nascimentos , Feminino , Humanos , Falência Renal Crônica/etiologia , Nefrite Lúpica/complicações , Período Pós-Operatório , Gravidez , Resultado da Gravidez
19.
Transplant Proc ; 51(7): 2257-2261, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31400969

RESUMO

INTRODUCTION: and Aim. End-stage renal disease owing to structural urologic anomalies is frequent in the pediatric population. Impaired bladder function is thought to have a negative effect on graft function and survival. The aim of this study was to present our single-center experience and long-term follow-up results in pediatric patients who underwent renal transplantation for urologic reasons and to compare graft survival among patients who underwent transplantation for nonurologic reasons. METHOD: The paper records of renal transplanted children (<18 years of age) held by Ege University Medical Faculty between 1998 and 2018 were evaluated retrospectively. Patients with normal bladder function who underwent transplantation for urologic reasons were defined as group A, whereas patients who had impaired bladder function and underwent transplantation for urologic reasons were defined as group B; a control group was defined as group C. RESULTS: Eighty-three patients were included in the study. The creatinine values of the patients at their last visit were no different between groups (P = .930). One-, 5-, and 10-year graft survival rates were 97%, 89%, and 74%, respectively, in group A; 100% for all years in group B; and 97%, 94%, and 80%, respectively, in group C. There was no statistically significant difference in terms of graft survival between groups (P = .351). CONCLUSION: Children with end-stage renal disease owing to urologic abnormalities may be good candidates for kidney transplantation with a favorable prognosis for graft function and survival.


Assuntos
Falência Renal Crônica/cirurgia , Transplante de Rim/mortalidade , Sistema Urinário/anormalidades , Doenças Urológicas/cirurgia , Adolescente , Criança , Creatinina/análise , Feminino , Seguimentos , Sobrevivência de Enxerto , Humanos , Falência Renal Crônica/sangue , Falência Renal Crônica/congênito , Masculino , Estudos Retrospectivos , Resultado do Tratamento , Doenças Urológicas/sangue , Doenças Urológicas/congênito
20.
Transplant Proc ; 51(7): 2289-2291, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31400971

RESUMO

INTRODUCTION: Amyloid A amyloidosis is most commonly caused by familial Mediterranean fever (FMF) in Turkey. Amyloidosis secondary to FMF is an important cause of end-stage renal failure, and kidney transplantation (KT) in these cases can be complicated, with long-term results oftentimes inferior compared with organ transplant in patients without FMF. The present study aims to show the long-term results of patients with secondary amyloidosis caused by FMF undergoing KT . METHODS: We enrolled 27 patients with a history of FMF amyloidosis undergoing KT and a control group of 614 patients undergoing KT between 2005 and 2018 at Ankara University Medical School. All data were recorded retrospectively from patients files. RESULTS: Twenty-two patients (81.5%) were treated with triple immunosuppressive therapy consisting of mycophenolate mofetil, tacrolimus, and a steroid; 5 patients (18.5%) were treated with tacrolimus, azathioprine, and prednisolone. Acute cellular rejection was seen in 3 patients (11.1%), and acute cellular- and antibody-mediated rejection occurred in 1 patient (3.7%). During the follow-up period, graft loss due to acute cellular rejection was observed in only 1 patient. One patient was lost to follow-up.


Assuntos
Amiloidose/etiologia , Febre Familiar do Mediterrâneo/complicações , Rejeição de Enxerto/epidemiologia , Falência Renal Crônica/cirurgia , Transplante de Rim/efeitos adversos , Adulto , Feminino , Rejeição de Enxerto/etiologia , Humanos , Falência Renal Crônica/etiologia , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Resultado do Tratamento , Turquia
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