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The risk of end-stage renal disease among living donor liver transplant recipients in the US
American Journal of Transplantation (login required)
Since initiation of model for end-stage liver disease (MELD)-based allocation for liver transplantation, the risk of posttransplant end-stage renal disease (ESRD) has increased. Recent U.S. data have demonstrated comparable, if not superior survival, among recipients of living donor liver transplants (LDLT) when compared to deceased donor liver transplant (DDLT) recipients. However, little is known about the incidence of ESRD post-LDLT.
ATC 2016 program proposals due June 5
Program proposals are being accepted for the 2016 American Transplant Congress ATC in Boston. The deadline to submit proposals is June 5, 2015.
QAPI Objective Measures webinar available online
Did you miss last Wednesday's webinar on Objective Measures? You can view the recording online. ASTS, AST, and the CMS Survey and Certification Group are pleased to provide this series on various Quality Assessment and Performance Improvement (QAPI) topics.
Registration open for OPTN/UNOS Liver Forum
The OPTN/UNOS Liver and Intestinal Organ Transplantation Committee is sponsoring an educational forum to seek additional input on concepts intended to increase equity in access to liver transplantation. The forum will be held June 22, 2015, at the Loews Chicago O'Hare Hotel and will also be available for live webinar participation.
Prediction of medication non-adherence and associated outcomes in pediatric kidney transplant recipients
Pediatric Tx (login required)
Studies have continued to evaluate risk factors associated with post-transplant non-adherence in pediatric patients. However, many of these studies fail to evaluate how risk factors can be utilized to predict MNA. The aims of this study were to (i) determine salient risk factors associated with MNA to develop an adequate predictive risk model and (ii) assess transplant outcomes based on the presence of MNA in a large, diverse cohort of pediatric KTX recipients.
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Outbreak of influenza A(H1N1) in a kidney transplant unit — protective effect of vaccination
American Journal of Transplantation (login required)
Seasonal influenza vaccination is recommended for patients with end-stage renal disease (ESRD), despite suggested inferior efficacy among these patients. We characterize an outbreak of influenza A(H1N1) in a kidney transplant unit. Altogether 23 patients were treated on the ward for postoperative care after kidney transplantation during the outbreak. After the first positive case, all patients were tested with nasopharyngeal swab tests and 7 patients were diagnosed with influenza A(H1N1).
Highly competitive geographic areas have a higher annual number of liver transplants
The annual number of liver transplantation operations increases when transplantation centers are concentrated in geographic areas that are highly competitive, according to findings from a new study published as an "article in press" in the Journal of the American College of Surgeons (JACS). The study, believed to be the first one to demonstrate a link between the volume of liver transplantation and competition for organs and geographic density, will appear in the print edition of the Journal this summer.
Donation after cardiac death liver transplantation: Graft quality evaluation based on pretransplant liver biopsy
Liver Transplantation (login required)
Donation after cardiac death (DCD) liver grafts are associated with inferior clinical outcomes and high discard rates because of poor graft quality. We investigated the predictive value of DCD liver biopsy for the pretransplant graft quality evaluation. DCD liver transplants that took place between October 2010 and April 2014 were included (n = 127). Histological features of graft biopsy samples were analyzed to assess risk factors for graft survival.
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Reassessing medical risk in living kidney donors
Journal of the American Society of Nephrology (login required)
The short- and long-term effects of unilateral nephrectomy on living donors have been important considerations for 60 years. Short-term risk is well established (0.03 percent mortality and less than 1 percent risk of major morbidity), but characterization of long-term risk is evolving. Relative to the general population, risk of mortality, ESRD, hypertension, proteinuria, and cardiovascular disease is comparable or lower.
Sex steroid levels in chronic kidney disease and kidney transplant recipients: Associations with disease severity and prediction of mortality
Chronic kidney disease (CKD) leads to dysfunction of the hypothalamic–pituitary–gonadal (HPG) axis in both sexes, and the severity of the endocrine dysfunction is proportional to the degree of renal impairment. The pathogenesis is complex and involves dysregulation of the HPG axis at multiple levels. Reductions in circulating sex steroid levels may not only lead to clinical hypogonadism, but may also play a role in the pathogenesis and progression of CKD. Most plausible is an indirect effect: in men, low levels of circulating testosterone have been associated with vascular disease and dysglycaemia, both risk factors for kidney disease.
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