T. Rana, L. Szabo, A. Asderakis, E. Ablorsu

Slides:



Advertisements
Similar presentations
Changes in graft function in long term renal transplant recipients – analysis by CKD stage and recipient characteristics U.P.Udayaraj, D.Ansell, R.Steenkamp,
Advertisements

L. Szabo P. Laftsidis E. Ablorsu Cardiff Transplant Unit Cardiff UK HYPOTHERMIC MACHINE PERFUSION IMPROVES OUTCOMES IN DCD KIDNEYS.
L. Szabo B. Cook A. Asderakis E. Ablorsu Cardiff Transplant Unit Cardiff UK HYPOTHERMIC MACHINE PERFUSION IMPROVES OUTCOMES IN DCD KIDNEYS WITH LONG COLD.
What makes a pancreas allograft marginal? Peter J Friend University of Oxford.
Allocation of elderly deceased donor kidneys Lisa Bradbury, Niaz Ahmad, Paul Gibbs, Richard Baker, Adam McLean, Chris Callaghan Renal Transplant Services.
Comparison of HTK and UW in Abdominal Transplantation Dr. Richard S. Mangus, MD MS Indiana University, School of Medicine.
Study of cytokine gene polymorphism and graft outcome in live-donor kidney transplantation By Rashad Hassan MD Amgad El-Agroudy, Ahmad Hamdy, Amani Mostafa.
The Expanded Criteria Donors in Kidney Transplantation: 3 Years Experience FAM Shaheen, B. Al-Attar, MZ Souqiyyeh, J.E Cillo, A. Al Sayyari.
Critical Appraisal Did the study address a clearly focused question? Did the study address a clearly focused question? Was the assignment of patients.
3 Patrick T Anderson, 2,3 Vivian McAlister, 1,3 Alp Sener, 1,3 Patrick P Luke Divisions of 1 Urology and 2 Surgery, Department of Surgery, 3 Schulich School.
Impact of Recipient and Donor Non-immunological factors on the Outcome of Expanded Criteria Deceased Donors Kidney Transplantation Dr Hajar Al Hayyan.
Relationship between coronary and renal artery disease and associated risk factors in hypertensive and diabetic patients undergoing coronary angiography.
Can we improve deceased donor kidney utilisation? Chris Callaghan National Clinical Lead for Abdominal Organ Utilisation, NHSBT Consultant Transplant Surgeon,
Is it possible to predict New Onset Diabetes After Transplantation (NODAT) in renal recipients using epidemiological data alone? Background NODAT is an.
Circulation. 2014;129: Association Between Plasma Triglycerides and High-Density Lipoprotein Cholesterol and Microvascular Kidney Disease and Retinopathy.
Bariatric Surgery for T2DM The STAMPEDE Trial. A.R. BMI 36.5 T2DM diagnosed age 24 On Metformin, glyburide  insulin Parents with T2DM, father on dialysis.
Preemptive Kidney Transplant (PKT) – the Optimal Therapy in ESRD Reference: Connie L. Davis. Preemptive transplantation and the transplant first initiative.
P Ferguson, R Hills, A Grech, L Kjeldsen, M Dennis, P Vyas, R Clark, N Russell, C Craddock, On behalf of the NCRI AML Working Group. An operational definition.
Hypomagnesemia and the Risk of New-Onset Diabetes Mellitus after Kidney Transplantation J Am Soc Nephrol 27: 1793–1800, 2016 순천향 대학병원 신장내과 강혜란.
Kidney Graft Survival Rates do not improve by era: the impact of factor “Age” E. Bertoni MD, A. Larti MD, G. Rosso MD and M. Salvadori MD Renal Unit –
Primary Cause of Kidney Failure in new ESRD patients at initiation, by ethnicity figure 2.1, combined.
An AKI project for critically ill cancer patients
UOG Journal Club: June 2017 Multicenter screening for pre-eclampsia by maternal factors and biomarkers at 11–13 weeks’ gestation: comparison with NICE.
The RAdial SAme Day DischArge after PCI The RASADDA-PCI trial
Alcohol, Other Drugs, and Health: Current Evidence July–August 2017
BUONA FUNZIONE RENALE DEI TRAPIANTI RENALI DA DONATORI ANZIANI VALUTATI CON CLEARANCE DELLA CREATININA SECONDO GAULT-COCKCROFT, CON DATI ECOGRAFICI E CON.
Fig 1 Trends in organ donors in the UK, 2000–10
Strategies to increase transplantation
Improved long-term graft function and similar height changes with very low-dose steroid versus late steroid withdrawal in pediatric renal transplantation.
Careggi University Hospital–
Pancreas Transplantation Committee
Kidney Transplantation.
Outcomes of bariatric surgery after renal transplant: single center experience in Kuwait Authors Gheith O, Al-Otaibi T, Nampoory MRN, Halim M, Saied T,
Enterprise | Interest Nothing to disclose.
Renal Unit-Careggi University Hospital-Florence-Italy
EFFICACY AND SAFETY OF ANTI-THYMOCYTE GLOBULIN (ATG) TREATMENT OF STEROID RESISTANT ACUTE REJECTION IN KIDNEY TRANSPLANTATION E. Bertoni, M. Biagini, M.
Copyright © 2001 American Medical Association. All rights reserved.
Diabetic Cardiovascular Disease Predicts Chronic Kidney Disease Awareness in the Kidney Early Evaluation Program Cardiorenal Med 2011;1:45–52 - DOI: /
Treatment With Continuous, Hyperfractionated, Accelerated Radiotherapy (CHART) For Non-Small Cell Lung Cancer (NSCLC): The Weston Park Hospital Experience.
Effect of Acute Kidney Injury on Chronic Kidney Disease Progression and Proteinuria: Initial Results from a Pilot Study Horne K1, Scott R1, Packington.
1: Cardiff Transplant Unit, University Hospital of Wales, Cardiff
Organ Utilisation Strategy
The Walton Centre NHS Foundation Trust, Liverpool, UK.
Spectrum of Infections in Renal Transplant
P689 THE ROLE OF NUTRITIONAL ASSESSMENT FOR SIMULTANEOUS
The Benefits of Early Enteral Nutrition in SPK transplant
Kidney Transplants in HIV Positive Patients
Laparoscopic vs Open Colonic Surgery: Long Term Survival
C. Chalklin, C. Colmont, A. Zaidi, J. Warden-Smith, E. Ablorsu
Liver only transplants in the UK Question 2: In terms of survival benefit.
The Utilization of Sequential Compression Devices Among Pregnant Women
Volume 2: End-Stage Renal Disease Chapter 4: Hospitalization
(1) Donor and Transplant Activity There has been an increase in the number of liver donors since 2007/08, with a concurrent mean 12% increase in.
Volume 2: End-Stage Renal Disease Chapter 6: Transplantation
Giuseppe Biondi Zoccai, MD
Pancreas Committee Spring 2017.
Organ transplantation: historical perspective and current practice
The Kidney Early Evaluation Program (KEEP): Program Design and Demographic Characteristics of the Population  Claudine T. Jurkovitz, MD, MPH, Yang Qiu,
Complication rates following 4-Fr versus 6-Fr transfemoral vascular access – prospective audit at a single centre Chung R1, Weller A1, Bowles C1, Sedgwick.
Cardiothoracic Transplantation: Recent Developments
Midlands Organ Donation Services Team
Tac vs Cyc Non DM Pt Post RTx
Validation of Minnesota Acute Gvhd Risk Score and Identification of New Factors Associated with Initial Response to Steroids: Not All Gvhd Is Created Equal:
Atlantic Cardiovascular Patient Outcomes Research Team
Arjang Djamali, Christina Kendziorski, Peter C. Brazy, Bryan N. Becker 
Three-year outcomes of revisional laparoscopic Gastric Bypass after failed laparoscopic Sleeve: A case-matched analysis T. Malinka, J. Zerkowski, Y.
Representative Light Micrographs of Kidney Sections Illustrating the Histologic Scoring Criteria Giuseppe Remuzzi, et al, N Engl J Med 2006;3354:
Deceased solid organ donors Recent trends from ANZOD
Dialysis outcomes in Australia & New Zealand
Demographic Characteristics of Cohort
Presentation transcript:

Early Single Centre Results of Dual Kidney Transplantation from Marginal Donors T. Rana, L. Szabo, A. Asderakis, E. Ablorsu Cardiff Transplant Unit, University Hospital of Wales, Cardiff, UK INTRODUCTION METHOD Increasing shortage of donor kidneys dictates constant review of organ quality and utilisation. Any positive result from a potential donor is superior to rejecting the organs outright. The most common reason for donor rejection was age with a positive past medical history, especially of Diabetes Mellitus (DM) and Hypertension (HTN). The results of graft survival and renal function from marginal donors with these characteristics has been demonstrated to be inferior to Standard Criteria Donors (SCD) in the past. The implantation of both kidneys from a marginal donor allows us to utilise organs that would either be rejected outright or provide insufficient graft function to the recipient. A comparison of graft function and complication rates was required to validate dual kidney transplantation. Donor selection criteria for Dual Kidney Transplant: DCD donors older than 70 years of age, DCD donors older than 65 with DM, HTN or both; & DBD donors older than 70 years of age with DM, HTN or both. Recipient exclusion factors: DM, Polycystic kidney disease, severe cardiovascular disease, treatment with Clopidogrel or Warfarin and BMI > 31. Transplant Technique: Both kidneys were implanted on the same side (ipsilateral). Method: We compared outcomes of consecutive Dual Kidney Transplant (DKT) between Feb 2011 and April 2014 with our historic single kidney transplant (SKT) recipient group with identical donor criteria to the DKT group. Data was collected prospectively in the DKT group and retrospectively in the earlier single transplant group. RESULTS Patients included: 34 DKTs vs 51 SKTs Median Recipient Age: (years) 67.5 vs. 65 (p = 0.02) Higher Mean eGFR: DKT vs SKT (see fig): - 6 months: 44.6 vs. 35.4 (p = 0.005) 12 months: 46.7 vs. 34.9 (p = 0.0009) Lower rate of DGF: (%) 79 vs. 82 (p = 0.73) Rejection rate: (%) 21 vs. 27 (p = 0.47) Mean Hospital stay: (days) 16 vs. 13 (p = 0.04) DKT Survival graft survival 1 year: dual 96%, single 96% 3 year: dual 96%, single 91% p-value: 0.62 patient survival 1 year: dual 92%, single 98% 3 year: dual 70%, single 91% p-value: 0.07 CONCLUSIONS Graft function and survival are improved by dual kidney transplantation when compared to single kidney transplants from similar donors. DKTs present a viable option in the utilisation of very marginal kidney donors. Careful selection of potential recipients is necessary due to the somewhat higher complication rate. Further studies are needed to consolidate evidence for this technique and gain wider acceptance in clinical practice. Pancreas and Islet 3