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Urinary Tract Disease
Published in Vincenzo Berghella, Maternal-Fetal Evidence Based Guidelines, 2022
Women with end-stage renal disease (ESRD) on dialysis should be counseled preconceptionally that they should receive a renal transplant and then wait 1–2 years before attempting pregnancy. Women on dialysis or with a recently transplanted kidney should be maintained on effective contraception. If pregnant, counseling should include review of the very high rates of the above complications. Intensive (>36 hour/week) hemodialysis significantly improves fetal outcomes in ESRD patients.
Transplantation and Organ Donation
Published in Ian Greaves, Keith Porter, Jeff Garner, Trauma Care Manual, 2021
Ian Greaves, Keith Porter, Jeff Garner
A successful transplant not only increases individual life expectancy and transforms the recipient’s quality of life but results in cost benefits to the NHS. Each of the 20,000 UK patients on haemodialysis costs the National Health Service (NHS) £30,000 per year, with the result that 3% of the total annual NHS budget is spent on kidney failure services. The cost of a kidney transplant (£17,000) and immunosuppression (£5000 per patient per year) over the average 12–14 year lifespan of a transplanted kidney saves the NHS approximately £200,000–300,000 per renal transplant and results in healthcare savings to the NHS of organ donation activity at around 360 million pounds.7
Lateral Hernias
Published in Jeff Garner, Dominic Slade, Manual of Complex Abdominal Wall Reconstruction, 2020
The single largest series of 112 cases compared those lateral incisions from renal transplantation with an equal number of lateral incisional hernias from other causes including appendicectomy, stoma closure, port site or donor nephrectomy retrieval sites. The repair was a direct open retromuscular one with dissection between internal and external oblique down to Cooper ligament and into the rectus sheath – there was no difference in outcomes, complications or recurrences between the two groups with a recurrence rate of 9.8% at a mean of 23 months’ follow-up. The point the authors make is that the immunosuppression of renal transplant patients does not affect outcome.23 Renard et al.'s technique of direct open repair with a preperitoneal mesh yielded a 6.5% recurrence rate and 9.7% chronic pain rate in 31 patients at about 2 years’ follow-up; most were from nephrectomies.17
Incidence, predictors, clinical outcomes, and economic burden of recurrent acute kidney injury: a retrospective cohort study
Published in Current Medical Research and Opinion, 2023
Shoroq M. Altawalbeh, Lina M. Wali, Osama Y. Alshogran, Eman A. Hammad, Linda Tahaineh
The electronic medical records at KAUH and JUH (2010–2019) were searched by specialized IT personnel to identify all admissions with ICD10 discharge codes of “N17” or ICD9 discharge codes of “584” that indicate AKI. Index admission was defined as the first AKI episode for eligible patients through the study period. Patients aged less than 18-years old, those with end-stage renal disease (ESRD) on dialysis before the index admission, and patients who had undergone a renal transplant were excluded from the study. Among eligible patients, patients who survived the index episode of AKI were classified into two groups based on having recurrent AKI episodes or not. Patients who did not have AKI recurrence and did not complete five years of follow-up were excluded (these included patients who did not have recurrent AKI and were admitted after 12/31/2014). In addition, patients who died during their first admission to the hospital were also excluded.
A nomogram predicts cardiovascular events in patients with peritoneal dialysis-associated peritonitis
Published in Renal Failure, 2022
Dan-dan Huang, Yuan-yuan Li, Xiang-ming Qi, Yong-gui Wu
The current study enrolled consecutive incidents of initial peritonitis in adult patients reported from June 1, 2015 to May 31, 2021, at the AnHui Medical University Affiliated Hospital in China. All PD-related peritonitis met the 2016 ISPD diagnostic criteria [9]. All patients with PD-related peritonitis were treated with 2 L of lactated peritoneal dialysis solution, containing 1.5% glucose and 2.5% glucose. The peritoneal dialysis mode is CAPD. Patients with PD for <3 months, renal transplant, hemodialysis in 3 months, recovered renal function, lost follow-up, or initiated PD in another health service were excluded. Furthermore, patients who refused to provide written consent were excluded. Eligible participants gave their informed consent. The study was in accordance with the provisions of the Declaration of Helsinki (as revised in 2013) [10].
Systematic review of programmed cell death-1 inhibitor therapy for advanced-stage cutaneous squamous cell carcinoma in solid-organ transplant recipients
Published in Journal of Dermatological Treatment, 2022
Hannah L. Hanania, Daniel J. Lewis
Additionally, case 16 represents a key example of the utility of re-transplantation if rejection does occur (24). Further study is necessary to weigh the safety of re-transplantation given that cSCC risk may increase with re-transplantation (39). Based on published cases, renal transplant patients appear to have a higher risk of rejection followed by liver, and heart transplants; however, the number of renal transplant patients treated without complications remains unknown (11). It is possible that renal and cardiac allografts may be more prone to rejection following ICI therapy given greater accessibility to lymphoid infiltration. Other factors influence the risk of rejection, such as immunosuppression dosing requirements, level of allograft matching, or the allograft being in situ for a shorter duration (40). We are unable to conclude whether the risk of rejection is higher with a specific organ allograft in our cohort based on the limited sample size.