1
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Pengel LHM, Kaisar M, Benjamens S, Ibrahim M, Ricci V, Bellini MI, Breithaupt-Faloppa AC, Falk C, Maple H, Marson L, Ortiz F, Papalois V, Paredes D, Forsberg A. Equity, Diversity and Inclusion (EDI) in Organ Transplantation: An ESOT Survey About EDI Within ESOT as an Organization and its Educational Activities, and Transplantation Research and Science. Transpl Int 2023; 36:11331. [PMID: 37680646 PMCID: PMC10481529 DOI: 10.3389/ti.2023.11331] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Accepted: 07/31/2023] [Indexed: 09/09/2023]
Abstract
The European Society of Organ Transplantation (ESOT) strives to promote equity, diversity, and inclusion (EDI) across all its activities. We surveyed the transplant community's experiences and perspectives regarding EDI within ESOT as an organization and its educational activities, and research in general. A total of 299 respondents completed the questionnaire. About half agreed that ESOT's Executive Committee, Council, and Sections/Committees are diverse and inclusive (51%) and that ESOT promotes EDI in its live and digital educational activities (54%). Forty percent of respondents agreed that scientific and clinical trials in the field of transplantation are diverse and inclusive. Despite the wide distribution of the survey, most of the respondents self-identified as White and were either physician or surgeon. However, the results contribute a unique insight into the experiences and perspectives of the transplantation community regarding EDI. Whilst ESOT is committed to the principles of EDI, perceptions and the high number of proposals show the apparent need to prioritize efforts to embed EDI across ESOT and transplantation science. These data should constitute a starting point for change and provide guidance for future efforts to promote EDI within the transplantation community.
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Affiliation(s)
- L. H. M. Pengel
- Erasmus MC Transplant Institute, University Medical Center, Rotterdam, Netherlands
- Peter Morris Centre for Evidence in Transplantation, Nuffield Department of Surgical Sciences, University of Oxford, Oxford, United Kingdom
| | - M. Kaisar
- Nuffield Department of Surgical Sciences, University of Oxford, Oxford, United Kingdom
| | - S. Benjamens
- Department of Surgery, Ikazia Hospital, Rotterdam, Netherlands
| | - M. Ibrahim
- Manchester Royal Infirmary, Manchester, United Kingdom
| | - V. Ricci
- European Society for Organ Transplantation, Padua, Italy
| | - M. I. Bellini
- Department of Surgery, Sapienza University of Rome, Rome, Italy
| | - A. C. Breithaupt-Faloppa
- LIM-11, Hospital das Clinicas da Faculdade de Medicina da Universidade de Sao Paulo, Sao Paulo, Brazil
| | - C. Falk
- Institut für Transplantationsimmunologie, Medizinische Hochschule Hannover, Hannover, Germany
| | - H. Maple
- Guy’s and St Thomas’ NHS Foundation Trust, London, United Kingdom
| | - L. Marson
- The Edinburgh Transplant Centre, Royal Infirmary of Edinburgh, Edinburgh, United Kingdom
| | - F. Ortiz
- Abdominal Center Unit, Nephrology, Helsinki University Hospital, Helsinki, Finland
| | - V. Papalois
- Imperial College Renal and Transplant Centre, Hammersmith Hospital, Imperial College Healthcare NHS Trust, London, United Kingdom
| | - D. Paredes
- Donation and Transplant Coordination Unit, Hospital Clinic Barcelona, University of Barcelona, Barcelona, Spain
| | - A. Forsberg
- Department of Health Sciences, Lund University, Lund, Sweden
- Department of Thoracic Surgery, Skane University Hospital, Lund, Sweden
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2
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Frutos MÁ, Crespo M, Valentín MDLO, Alonso-Melgar Á, Alonso J, Fernández C, García-Erauzkin G, González E, González-Rinne AM, Guirado L, Gutiérrez-Dalmau A, Huguet J, Moral JLLD, Musquera M, Paredes D, Redondo D, Revuelta I, Hofstadt CJVD, Alcaraz A, Alonso-Hernández Á, Alonso M, Bernabeu P, Bernal G, Breda A, Cabello M, Caro-Oleas JL, Cid J, Diekmann F, Espinosa L, Facundo C, García M, Gil-Vernet S, Lozano M, Mahillo B, Martínez MJ, Miranda B, Oppenheimer F, Palou E, Pérez-Saez MJ, Peri L, Rodríguez O, Santiago C, Tabernero G, Hernández D, Domínguez-Gil B, Pascual J. Erratum to "Recommendations for living donor kidney transplantation". Nefrologia 2023:S2013-2514(23)00024-X. [PMID: 36842855 DOI: 10.1016/j.nefroe.2023.02.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Accepted: 01/27/2023] [Indexed: 02/28/2023] Open
Affiliation(s)
| | - Marta Crespo
- Nephrology Department, Hospital del Mar, Barcelona, Spain
| | | | | | - Juana Alonso
- Nephrology Department, Hospital Regional Universitario de Málaga, Spain
| | | | | | - Esther González
- Nephrology Department, Hospital Universitario 12 Octubre, Spain
| | | | - Lluis Guirado
- Nephrology Department, Fundacio Puigvert, Barcelona, Spain
| | | | - Jorge Huguet
- RT Surgical Team, Fundació Puigvert, Barcelona, Spain
| | | | - Mireia Musquera
- Urology Department, Hospital Clinic Universitari, Barcelona, Spain
| | - David Paredes
- Donation and Transplantation Coordination Department, Hospital Clinic Universitari, Barcelona, Spain
| | | | - Ignacio Revuelta
- Nephrology and RT Department, Hospital Clinic Universitari, Barcelona, Spain
| | | | - Antonio Alcaraz
- Urology Department, Hospital Clinic Universitari, Barcelona, Spain
| | | | - Manuel Alonso
- Regional Transplantation Coordination, Seville, Spain
| | | | - Gabriel Bernal
- Nephrology Department, Hospital Universitario Virgen del Rocío, Seville, Spain
| | - Alberto Breda
- RT Surgical Team, Fundació Puigvert, Barcelona, Spain
| | - Mercedes Cabello
- Nephrology Department, Hospital Regional Universitario de Málaga, Spain
| | | | - Joan Cid
- Apheresis and Cell Therapy Unit, Haemotherapy and Haemostasis Department, Hospital Clinic Universitari, Barcelona, Spain
| | - Fritz Diekmann
- Nephrology and RT Department, Hospital Clinic Universitari, Barcelona, Spain
| | - Laura Espinosa
- Paediatric Nephrology Department, Hospital La Paz, Madrid, Spain
| | - Carme Facundo
- Nephrology Department, Fundacio Puigvert, Barcelona, Spain
| | | | | | - Miquel Lozano
- Apheresis and Cell Therapy Unit, Haemotherapy and Haemostasis Department, Hospital Clinic Universitari, Barcelona, Spain
| | | | | | | | | | - Eduard Palou
- Immunology Department, Hospital Clinic i Universitari, Barcelona, Spain
| | | | - Lluis Peri
- Urology Department, Hospital Clinic Universitari, Barcelona, Spain
| | | | | | - Guadalupe Tabernero
- Nephrology Department, Servicio de Nefrología, Hospital Universitario de Salamanca, Spain
| | - Domingo Hernández
- Nephrology Department, Hospital Regional Universitario de Málaga, Spain
| | | | - Julio Pascual
- Nephrology Department, Hospital del Mar, Barcelona, Spain
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3
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Frutos MÁ, Crespo M, Valentín MDLO, Alonso-Melgar Á, Alonso J, Fernández C, García-Erauzkin G, González E, González-Rinne AM, Guirado L, Gutiérrez-Dalmau A, Huguet J, López del Moral JL, Musquera M, Paredes D, Redondo D, Revuelta I, Van-der Hofstadt CJ, Alcaraz A, Alonso-Hernández Á, Alonso M, Bernabeu P, Bernal G, Breda A, Cabello M, Caro-Oleas JL, Cid J, Diekmann F, Espinosa L, Facundo C, García M, Gil-Vernet S, Lozano M, Mahillo B, Martínez MJ, Miranda B, Oppenheimer F, Palou E, Pérez-Saez MJ, Peri L, Rodríguez O, Santiago C, Tabernero G, Hernández D, Domínguez-Gil B, Pascual J. Fe de errores de «Recomendaciones para el trasplante renal de donante vivo». Nefrologia 2023. [DOI: 10.1016/j.nefro.2023.01.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
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4
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Calzada Y, Revuelta I, Codina E, Alcaraz A, López-Báez V, Paredes D, Arango P, Palou E, Garcia-Herrera A, Oppenheimer F, Diekmann F, Madrid Á. Overcoming limits: First ABO incompatible living donor paired kidney transplant in an hypersensitized pediatric recipient in Spain. Pediatr Transplant 2022; 26:e14359. [PMID: 35842929 DOI: 10.1111/petr.14359] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Revised: 05/11/2022] [Accepted: 06/28/2022] [Indexed: 11/28/2022]
Abstract
INTRODUCTION HLA sensitization is a growing problem in children awaiting kidney transplantation. In some cases, finding an immunologically compatible donor entails contemplating the option of an ABO incompatible transplant or paired transplant. METHODS Patient with genetic nephrotic syndrome and progressive chronic kidney disease, with a previous thrombosis of a first kidney transplant, resulting hypersensitized and remaining for a long-time on hemodialysis. Despite a desensitization strategy, family members were incompatible and deceased donation options must be ruled out due to the presentation of donor-specific antibodies (DSA). After 4 years, the possibility arises to perform a kidney paired transplant with a 62-year-old woman with an incompatible blood group. Although the current cytotoxicity- and cell-based crossmatches were negative, history of DSA were recorded. RESULTS An intensive ABO and HLA desensitization protocol was performed in order to combat the isohemagglutinin antibodies and on the memory-HLA, based on rituximab, apheresis sessions, and immunoglobulins. Despite the donor being older in terms of pediatric transplantation, the donor-recipient weight difference, and immunological risk, the transplant was completed successfully. Maintenance of titration of up to 1/2 was confirmed after 3 weeks post-transplant (IgM and IgG). Kidney biopsy at 2 weeks and 6 months without signs of rejection. The patient is currently 12 months post-transplant and has not presented any signs of transplant rejection and has proper renal function. CONCLUSIONS Kidney paired transplantation is an excellent solution for hypersensitized children, and ABO incompatibility can be considered to increase their options to find a good donor, without thereby obtaining worse results.
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Affiliation(s)
- Yolanda Calzada
- Pediatric Nephrology and Renal Transplant Department, Hospital Sant Joan de Déu, Barcelona, Spain
| | - Ignacio Revuelta
- Nephrology and Renal Transplant Department, Hospital Clínic, Barcelona, Spain.,Laboratori Experimental de Nefrologia i Trasplantament (LENIT), Institut d'Investigacions, Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.,Department of Medicine, University of Barcelona, Barcelona, Spain.,Red de Investigación Renal (REDINREN), Madrid, Spain
| | - Elena Codina
- Pediatric Nephrology and Renal Transplant Department, Hospital Sant Joan de Déu, Barcelona, Spain
| | - Antonio Alcaraz
- Department of Urology, Hospital Clinic Barcelona, Barcelona, Spain
| | - Víctor López-Báez
- Pediatric Nephrology and Renal Transplant Department, Hospital Sant Joan de Déu, Barcelona, Spain
| | - David Paredes
- Donation and Transplant Coordination Section, Hospital Clinic Barcelona, Barcelona, Spain
| | - Pedro Arango
- Pediatric Nephrology and Renal Transplant Department, Hospital Sant Joan de Déu, Barcelona, Spain
| | - Eduard Palou
- Department of Medicine, University of Barcelona, Barcelona, Spain.,Department of Immunology, Hospital Clinic de Barcelona, Barcelona, Spain
| | - Adriana Garcia-Herrera
- Department of Medicine, University of Barcelona, Barcelona, Spain.,Department of Pathology, Hospital Clínic de Barcelona, Barcelona, Spain
| | - Federico Oppenheimer
- Nephrology and Renal Transplant Department, Hospital Clínic, Barcelona, Spain.,Laboratori Experimental de Nefrologia i Trasplantament (LENIT), Institut d'Investigacions, Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.,Department of Medicine, University of Barcelona, Barcelona, Spain.,Red de Investigación Renal (REDINREN), Madrid, Spain
| | - Fritz Diekmann
- Nephrology and Renal Transplant Department, Hospital Clínic, Barcelona, Spain.,Laboratori Experimental de Nefrologia i Trasplantament (LENIT), Institut d'Investigacions, Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.,Department of Medicine, University of Barcelona, Barcelona, Spain.,Red de Investigación Renal (REDINREN), Madrid, Spain
| | - Álvaro Madrid
- Pediatric Nephrology and Renal Transplant Department, Hospital Sant Joan de Déu, Barcelona, Spain
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5
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Frutos MÁ, Crespo M, Valentín MDLO, Alonso-Melgar Á, Alonso J, Fernández C, García-Erauzkin G, González E, González-Rinne AM, Guirado L, Gutiérrez-Dalmau A, Huguet J, Moral JLLD, Musquera M, Paredes D, Redondo D, Revuelta I, Hofstadt CJVD, Alcaraz A, Alonso-Hernández Á, Alonso M, Bernabeu P, Bernal G, Breda A, Cabello M, Caro-Oleas JL, Cid J, Diekmann F, Espinosa L, Facundo C, García M, Gil-Vernet S, Lozano M, Mahillo B, Martínez MJ, Miranda B, Oppenheimer F, Palou E, Pérez-Saez MJ, Peri L, Rodríguez O, Santiago C, Tabernero G, Hernández D, Domínguez-Gil B, Pascual J. Recommendations for living donor kidney transplantation. Nefrologia 2022; 42 Suppl 2:5-132. [PMID: 36503720 DOI: 10.1016/j.nefroe.2022.07.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Accepted: 10/26/2021] [Indexed: 06/17/2023] Open
Abstract
This Guide for Living Donor Kidney Transplantation (LDKT) has been prepared with the sponsorship of the Spanish Society of Nephrology (SEN), the Spanish Transplant Society (SET), and the Spanish National Transplant Organization (ONT). It updates evidence to offer the best chronic renal failure treatment when a potential living donor is available. The core aim of this Guide is to supply clinicians who evaluate living donors and transplant recipients with the best decision-making tools, to optimise their outcomes. Moreover, the role of living donors in the current KT context should recover the level of importance it had until recently. To this end the new forms of incompatible HLA and/or ABO donation, as well as the paired donation which is possible in several hospitals with experience in LDKT, offer additional ways to treat renal patients with an incompatible donor. Good results in terms of patient and graft survival have expanded the range of circumstances under which living renal donors are accepted. Older donors are now accepted, as are others with factors that affect the decision, such as a borderline clinical history or alterations, which when evaluated may lead to an additional number of transplantations. This Guide does not forget that LDKT may lead to risk for the donor. Pre-donation evaluation has to centre on the problems which may arise over the short or long-term, and these have to be described to the potential donor so that they are able take them into account. Experience over recent years has led to progress in risk analysis, to protect donors' health. This aspect always has to be taken into account by LDKT programmes when evaluating potential donors. Finally, this Guide has been designed to aid decision-making, with recommendations and suggestions when uncertainties arise in pre-donation studies. Its overarching aim is to ensure that informed consent is based on high quality studies and information supplied to donors and recipients, offering the strongest possible guarantees.
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Affiliation(s)
| | - Marta Crespo
- Nephrology Department, Hospital del Mar, Barcelona, Spain
| | | | | | - Juana Alonso
- Nephrology Department, Hospital Regional Universitario de Málaga, Spain
| | | | | | - Esther González
- Nephrology Department, Hospital Universitario 12 Octubre, Spain
| | | | - Lluis Guirado
- Nephrology Department, Fundacio Puigvert, Barcelona, Spain
| | | | - Jorge Huguet
- RT Surgical Team, Fundació Puigvert, Barcelona, Spain
| | | | - Mireia Musquera
- Urology Department, Hospital Clinic Universitari, Barcelona, Spain
| | - David Paredes
- Donation and Transplantation Coordination Department, Hospital Clinic Universitari, Barcelona, Spain
| | | | - Ignacio Revuelta
- Nephrology and RT Department, Hospital Clinic Universitari, Barcelona, Spain
| | | | - Antonio Alcaraz
- Urology Department, Hospital Clinic Universitari, Barcelona, Spain
| | | | - Manuel Alonso
- Regional Transplantation Coordination, Seville, Spain
| | | | - Gabriel Bernal
- Nephrology Department, Hospital Universitario Virgen del Rocío, Seville, Spain
| | - Alberto Breda
- RT Surgical Team, Fundació Puigvert, Barcelona, Spain
| | - Mercedes Cabello
- Nephrology Department, Hospital Regional Universitario de Málaga, Spain
| | | | - Joan Cid
- Apheresis and Cell Therapy Unit, Haemotherapy and Haemostasis Department, Hospital Clinic Universitari, Barcelona, Spain
| | - Fritz Diekmann
- Nephrology and RT Department, Hospital Clinic Universitari, Barcelona, Spain
| | - Laura Espinosa
- Paediatric Nephrology Department, Hospital La Paz, Madrid, Spain
| | - Carme Facundo
- Nephrology Department, Fundacio Puigvert, Barcelona, Spain
| | | | | | - Miquel Lozano
- Apheresis and Cell Therapy Unit, Haemotherapy and Haemostasis Department, Hospital Clinic Universitari, Barcelona, Spain
| | | | | | | | | | - Eduard Palou
- Immunology Department, Hospital Clinic i Universitari, Barcelona, Spain
| | | | - Lluis Peri
- Urology Department, Hospital Clinic Universitari, Barcelona, Spain
| | | | | | | | - Domingo Hernández
- Nephrology Department, Hospital Regional Universitario de Málaga, Spain
| | | | - Julio Pascual
- Nephrology Department, Hospital del Mar, Barcelona, Spain.
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6
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Ventura-Aguiar P, Bayés-Genís B, Amor AJ, Cuatrecasas M, Diekmann F, Esmatjes E, Ferrer-Fàbrega J, García-Criado Á, Musquera M, Olivella S, Palou E, Paredes D, Perea S, Perez A, Poch E, Romano B, Escarrabill J. Patient Experience in Pancreas-Kidney Transplantation-A Methodological Approach Towards Innovation in an Established Program. Transpl Int 2022; 35:10223. [PMID: 35497883 PMCID: PMC9047730 DOI: 10.3389/ti.2022.10223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Accepted: 02/15/2022] [Indexed: 11/13/2022]
Abstract
Simultaneous pancreas-kidney transplantation (SPKT) leads to increased survival and quality of life, and is an alternative treatment for insulin-dependent diabetes mellitus and end-stage kidney disease. Due to the particularities of this population (often with multiple comorbidities) and of the surgery (only performed in a few centers), a comprehensive analysis of patients' experience along the SPKT process is crucial to improve patient care and add value to this procedure. Therefore, we applied a systematic and iterative methodology with the participation of both patients and professional teams working together to explore and identify unmet needs and value-adding steps along the transplant patient journey at an established pancreas transplant program. Four main steps (to comprehend, to explore, to experiment and to assess) led to several interventions around three major areas: Administration and logistics, information and communication, and perceived quality of assistance. As a result, both displacements to the hospital for diagnostic purposes and the time delay involved in joining the patient waiting list for transplantation were reduced in parallel to the administrative procedures. In conclusion, the methodological implementation of key organizational changes has great impact on overall patient experience. Further quantitative analysis from the patient's perspective will consolidate our program and may add new prototype service design components.
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Affiliation(s)
- Pedro Ventura-Aguiar
- Nephrology and Kidney Transplant Department, Hospital Clinic Barcelona, Barcelona, Spain.,Laboratori Experimental de Nefrologia i Trasplantament, Fundació Clínic, August Pi i Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain
| | - Beatriu Bayés-Genís
- Nephrology and Kidney Transplant Department, Hospital Clinic Barcelona, Barcelona, Spain.,Laboratori Experimental de Nefrologia i Trasplantament, Fundació Clínic, August Pi i Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain
| | - Antonio J Amor
- Endocrinology Department, Hospital Clinic Barcelona, Barcelona, Spain
| | - Miriam Cuatrecasas
- Pathology Department, Center for Biomedical Diagnosis, Hospital Clinic Barcelona, Barcelona, Spain
| | - Fritz Diekmann
- Nephrology and Kidney Transplant Department, Hospital Clinic Barcelona, Barcelona, Spain.,Laboratori Experimental de Nefrologia i Trasplantament, Fundació Clínic, August Pi i Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain.,Red de Investigación Renal (REDINREN), Madrid, Spain
| | - Enric Esmatjes
- Endocrinology Department, Hospital Clinic Barcelona, Barcelona, Spain
| | - Joana Ferrer-Fàbrega
- Hepato-Bilio-Pancreatic Surgery and Digestive Transplant Unit, Hospital Clinic Barcelona, Barcelona, Spain
| | - Ángeles García-Criado
- Radiology Department, Center for Imaging Diagnosis, Hospital Clinic Barcelona, Barcelona, Spain
| | - Mireia Musquera
- Urology Department, Hospital Clinic Barcelona, Barcelona, Spain
| | - Silvia Olivella
- Nephrology and Kidney Transplant Department, Hospital Clinic Barcelona, Barcelona, Spain
| | - Eva Palou
- Patient Experience, Hospital Clinic Barcelona, Barcelona, Spain
| | - David Paredes
- Transplant Coordination Department, Hospital Clinic Barcelona, Barcelona, Spain
| | - Sonia Perea
- Nephrology and Kidney Transplant Department, Hospital Clinic Barcelona, Barcelona, Spain
| | - Anna Perez
- Nephrology and Kidney Transplant Department, Hospital Clinic Barcelona, Barcelona, Spain
| | - Esteban Poch
- Nephrology and Kidney Transplant Department, Hospital Clinic Barcelona, Barcelona, Spain
| | - Barbara Romano
- Nephrology and Kidney Transplant Department, Hospital Clinic Barcelona, Barcelona, Spain
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7
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Ferrer-Fàbrega J, Folch-Puy E, Lozano JJ, Ventura-Aguiar P, Cárdenas G, Paredes D, García-Criado Á, Bombí JA, García-Pérez R, López-Boado MÁ, Rull R, Esmatjes E, Ricart MJ, Diekmann F, Fondevila C, Fernández-Cruz L, Fuster J, García-Valdecasas JC. Current Trends in Organ Preservation Solutions for Pancreas Transplantation: A Single-Center Retrospective Study. Transpl Int 2022; 35:10419. [PMID: 35418805 PMCID: PMC8995432 DOI: 10.3389/ti.2022.10419] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Accepted: 02/25/2022] [Indexed: 12/14/2022]
Abstract
Due to the high vulnerability of the pancreas to ischemia-reperfusion injury, choices regarding preservation solution markedly affect pancreas transplant success. A retrospective single-center analysis of 380 pancreas transplants (2000–2019) was performed to correlate current preservation solutions with transplant outcomes. Early graft failure requiring transplantectomy within 30 days post-transplant occurred in 7.5% for University of Wisconsin (UW) group (n = 267), 10.8% of Celsior (CS) group (n = 83), 28.5% of Histidine-Tryptophan-Ketoglutarate (HTK) group (n = 7), and none for Institut Georges Lopez-1 (IGL-1) group (n = 23). The most common causes of technical failures in this cohort included abdominal hemorrhage (8.4%); graft pancreatitis (3.7%); fluid collections (2.6%); intestinal complications (6.6%); and vascular thrombosis (20.5%). Although IGL-1 solution provided lower surgical complication rates, no significant differences were found between studied groups. Nevertheless, HTK solution was associated with elevated pancreatitis rates. The best graft survival was achieved at 1 year using UW and IGL-1, and at 3 and 5 years using IGL-1 (p = 0.017). There were no significant differences in patient survival after a median follow-up of 118.4 months. In this setting therefore, IGL-1 solution appears promising for perfusion and organ preservation in clinical pancreas transplantation, compared to other commonly used solutions.
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Affiliation(s)
- Joana Ferrer-Fàbrega
- Hepatobiliopancreatic Surgery and Liver and Pancreatic Transplantation Unit, Clinic Institute of Digestive and Metabolic Diseases (ICMDiM), Hospital Clínic, University of Barcelona, Barcelona, Spain.,August Pi i Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain
| | - Emma Folch-Puy
- Experimental Pathology Department, Institut d'Investigacions Biomèdiques de Barcelona (IIBB), Consejo Superior de Investigaciones Científicas (CSIC), Barcelona, Spain.,August Pi i Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain
| | - Juan José Lozano
- Bioinformatics Platform, Network for Biomedical Research in Hepatic and Digestive Diseases (CIBERehd), Barcelona, Spain.,Network for Biomedical Research in Hepatic and Digestive Diseases (CIBERehd), Barcelona, Spain
| | - Pedro Ventura-Aguiar
- Renal Transplant Unit, Nephrology and Kidney Transplant Department, Hospital Clínic, University of Barcelona, Barcelona, Spain.,August Pi i Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain
| | - Gabriel Cárdenas
- Hepatobiliopancreatic Surgery and Liver and Pancreatic Transplantation Unit, Clinic Institute of Digestive and Metabolic Diseases (ICMDiM), Hospital Clínic, University of Barcelona, Barcelona, Spain
| | - David Paredes
- Donation and Transplant Coordination Unit, Hospital Clínic, University of Barcelona, Barcelona, Spain
| | - Ángeles García-Criado
- Department of Radiology, Hospital Clínic, University of Barcelona, Barcelona, Spain.,August Pi i Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain
| | - Josep Antoni Bombí
- Department of Pathology, Hospital Clínic, University of Barcelona, Barcelona, Spain
| | - Rocío García-Pérez
- Hepatobiliopancreatic Surgery and Liver and Pancreatic Transplantation Unit, Clinic Institute of Digestive and Metabolic Diseases (ICMDiM), Hospital Clínic, University of Barcelona, Barcelona, Spain
| | - Miguel Ángel López-Boado
- Hepatobiliopancreatic Surgery and Liver and Pancreatic Transplantation Unit, Clinic Institute of Digestive and Metabolic Diseases (ICMDiM), Hospital Clínic, University of Barcelona, Barcelona, Spain
| | - Ramón Rull
- Hepatobiliopancreatic Surgery and Liver and Pancreatic Transplantation Unit, Clinic Institute of Digestive and Metabolic Diseases (ICMDiM), Hospital Clínic, University of Barcelona, Barcelona, Spain
| | - Enric Esmatjes
- Diabetes Unit, Department of Endocrinology and Nutrition, Hospital Clínic, University of Barcelona, Barcelona, Spain.,August Pi i Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain
| | - Maria José Ricart
- Renal Transplant Unit, Nephrology and Kidney Transplant Department, Hospital Clínic, University of Barcelona, Barcelona, Spain
| | - Fritz Diekmann
- Renal Transplant Unit, Nephrology and Kidney Transplant Department, Hospital Clínic, University of Barcelona, Barcelona, Spain.,August Pi i Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain
| | - Constantino Fondevila
- Hepatobiliopancreatic Surgery and Liver and Pancreatic Transplantation Unit, Clinic Institute of Digestive and Metabolic Diseases (ICMDiM), Hospital Clínic, University of Barcelona, Barcelona, Spain.,Network for Biomedical Research in Hepatic and Digestive Diseases (CIBERehd), Barcelona, Spain.,August Pi i Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain
| | - Laureano Fernández-Cruz
- Hepatobiliopancreatic Surgery and Liver and Pancreatic Transplantation Unit, Clinic Institute of Digestive and Metabolic Diseases (ICMDiM), Hospital Clínic, University of Barcelona, Barcelona, Spain
| | - Josep Fuster
- Hepatobiliopancreatic Surgery and Liver and Pancreatic Transplantation Unit, Clinic Institute of Digestive and Metabolic Diseases (ICMDiM), Hospital Clínic, University of Barcelona, Barcelona, Spain.,Network for Biomedical Research in Hepatic and Digestive Diseases (CIBERehd), Barcelona, Spain.,August Pi i Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain
| | - Juan Carlos García-Valdecasas
- Hepatobiliopancreatic Surgery and Liver and Pancreatic Transplantation Unit, Clinic Institute of Digestive and Metabolic Diseases (ICMDiM), Hospital Clínic, University of Barcelona, Barcelona, Spain.,Network for Biomedical Research in Hepatic and Digestive Diseases (CIBERehd), Barcelona, Spain.,August Pi i Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain
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8
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Arana C, Cofan F, Ruiz P, Hermida E, Fernández J, Colmenero J, Forns X, Escude L, Cucchiari D, Moreno A, Bodro M, Herrera S, Rodriguez C, Paredes D, Diekmann F. PRIMARY HERPES SIMPLEX VIRUS TYPE 1 INFECTION WITH ACUTE LIVER FAILURE IN SOLID ORGAN TRANSPLANTATION: REPORT OF THREE CASES AND REVIEW. IDCases 2022; 28:e01485. [PMID: 35392601 PMCID: PMC8980616 DOI: 10.1016/j.idcr.2022.e01485] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Revised: 01/31/2022] [Accepted: 03/23/2022] [Indexed: 11/20/2022] Open
Abstract
Herpes virus infections is not uncommon in solid organ transplantation patients. We report 3 cases with primary Herpes simplex virus type-1 (HSV1) infection with acute liver failure (ALF). This is a rare and potentially fatal entity that could be a donor-derived infection. Although the initial clinical presentation is non-specific, it should be considered as a differential diagnosis in HSV-negative serology patients with liver failure and empirical treatment must be started in combination with a drastic reduction of immunosuppression. A strategy of HSV prophylaxis for pre-transplant HSV seronegative patients must be stablished in order to reduce the risk of clinical disease. HSV hepatitis is a rare and fatal entity that can be a donor-derived infection. It should be suspected in highly immunosuppressed transplant patients who develop acute liver failure. The treatment delay is associated with higher fatality. In transplant patients with negative HSV serology, prophylaxis is recommended if they are not with prophylaxis for CMV.
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9
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MOHAMMED H, Paredes D, De Freitas L. POS-783 ORGAN DONATION IN A DEVELOPING CARIBBEAN COUNTRY: THE TRINIDAD AND TOBAGO EXPERIENCE. Kidney Int Rep 2022. [DOI: 10.1016/j.ekir.2022.01.819] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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10
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Balleste C, Coll A, Valero R, Paredes D, Diekmann F, Torregrosa V, Colmenero J. New technologies applied to master education in the time of COVID-19. Korean Journal of Transplantation 2021. [DOI: 10.4285/atw2021.or-1061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Affiliation(s)
- Chloe Balleste
- International Cooperation, Donation and Transplantation Institute, Barcelona, Spain
| | - Alba Coll
- International Cooperation, Donation and Transplantation Institute, Barcelona, Spain
| | - Ricard Valero
- Department of Surgery and Surgical Specializations, University of Barcelona, Barcelona, Spain
| | - David Paredes
- Department of Surgery and Surgical Specializations, University of Barcelona, Barcelona, Spain
| | - Fritz Diekmann
- Department of Surgery and Surgical Specializations, University of Barcelona, Barcelona, Spain
| | - Vicens Torregrosa
- Department of Surgery and Surgical Specializations, University of Barcelona, Barcelona, Spain
| | - Jordi Colmenero
- Department of Surgery and Surgical Specializations, University of Barcelona, Barcelona, Spain
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11
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Rodríguez-Villar C, Paredes D, Roque R, Reinoso J, Sanchez-Etayo G. Clinical Utility and Evolution of Donor Serum Lactate During Normothermic Regional Perfusion in Uncontrolled Donation After Circulatory Death. Transplant Proc 2021; 53:2650-2654. [PMID: 34607713 DOI: 10.1016/j.transproceed.2021.05.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Revised: 05/14/2021] [Accepted: 05/20/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND Kidney transplantation from uncontrolled donor after circulatory death (uDCD) showed a higher incidence of delayed graft function and primary failure. The aim of this study was to study basal and kinetic evolution of lactate values in uDCD preserved on normothermic regional perfusion (NRP) as a predictive factor of kidney suitability exposed to prolong ischemic conditions. METHODS Descriptive and prospective study of a cohort of out-of-hospital cardiac arrest patients admitted to the emergency room as potential uDCD. Donors meeting the inclusion criteria were preserved on NRP for at least 2 hours before procurement. Serum lactate levels were determined at arrival as basal level and at 30 minutes intervals and compared with adequate renal perfusion in the operating room (OR). RESULTS Forty-five donors met inclusion criteria. Of these, 38 went to the OR (84.5%). No differences were found in basal lactate between accepted and rejected kidneys (203.08 ± 59.21 vs 175.43 ± 75.32 mg/dL, respectively); neither lactate, hematologic, hepatic transaminases, creatinine, or blood gas analysis sequential values evolved while on NRP. Lactate receiver operating characteristic curve failed to predict viability at different time points and did not correlate with the macroscopic kidney poor perfusion in the OR. CONCLUSIONS The baseline and kinetic evolution of plasma lactate values while on NRP, were not useful tools to predict the final OR kidney viability owing to previous severe ischemic insult.
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Affiliation(s)
- Camino Rodríguez-Villar
- Donation and Transplant Coordination Unit, Hospital Clinic of Barcelona, University of Barcelona, Barcelona, Spain.
| | - David Paredes
- Donation and Transplant Coordination Unit, Hospital Clinic of Barcelona, University of Barcelona, Barcelona, Spain
| | - Rebeca Roque
- Donation and Transplant Coordination Unit, Hospital Clinic of Barcelona, University of Barcelona, Barcelona, Spain
| | - Johanna Reinoso
- Donation and Transplant Coordination Unit, Hospital Clinic of Barcelona, University of Barcelona, Barcelona, Spain
| | - Gerard Sanchez-Etayo
- Donation and Transplant Coordination Unit, Hospital Clinic of Barcelona, University of Barcelona, Barcelona, Spain
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12
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De Beule J, Vandendriessche K, Pengel LHM, Bellini MI, Dark JH, Hessheimer AJ, Kimenai HJAN, Knight SR, Neyrinck AP, Paredes D, Watson CJE, Rega F, Jochmans I. A systematic review and meta-analyses of regional perfusion in donation after circulatory death solid organ transplantation. Transpl Int 2021; 34:2046-2060. [PMID: 34570380 DOI: 10.1111/tri.14121] [Citation(s) in RCA: 48] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Revised: 09/16/2021] [Accepted: 09/20/2021] [Indexed: 12/29/2022]
Abstract
In donation after circulatory death (DCD), (thoraco)abdominal regional perfusion (RP) restores circulation to a region of the body following death declaration. We systematically reviewed outcomes of solid organ transplantation after RP by searching PubMed, Embase, and Cochrane libraries. Eighty-eight articles reporting on outcomes of liver, kidney, pancreas, heart, and lung transplants or donor/organ utilization were identified. Meta-analyses were conducted when possible. Methodological quality was assessed using National Institutes of Health (NIH)-scoring tools. Case reports (13/88), case series (44/88), retrospective cohort studies (35/88), retrospective matched cohort studies (5/88), and case-control studies (2/88) were identified, with overall fair quality. As blood viscosity and rheology change below 20 °C, studies were grouped as hypothermic (HRP, ≤20 °C) or normothermic (NRP, >20 °C) regional perfusion. Data demonstrate that RP is a safe alternative to in situ cold preservation (ISP) in uncontrolled and controlled DCDs. The scarce HRP data are from before 2005. NRP appears to reduce post-transplant complications, especially biliary complications in controlled DCD livers, compared with ISP. Comparisons for kidney and pancreas with ISP are needed but there is no evidence that NRP is detrimental. Additional data on NRP in thoracic organs are needed. Whether RP increases donor or organ utilization needs further research.
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Affiliation(s)
- Julie De Beule
- Transplantation Research Group, Department of Microbiology, Immunology, and Transplantation, KU Leuven, Leuven, Belgium
| | | | - Liset H M Pengel
- Nuffield Department of Surgical Sciences, Centre for Evidence in Transplantation, University of Oxford, Oxford, UK
| | - Maria Irene Bellini
- Department of Emergency Medicine and Surgery, Azienda Ospedaliera San Camillo Forlanini, Rome, Italy
| | - John H Dark
- Faculty of Medical Sciences, Translational and Clinical Research Institute, Newcastle University, Newcastle, UK
| | - Amelia J Hessheimer
- Department of General & Digestive Surgery, Institut Clínic de Malalties Digestives i Metabòliques (ICMDM), Hospital Clínic, IDIBAPS, CIBERehd, University of Barcelona, Barcelona, Spain
| | - Hendrikus J A N Kimenai
- Division of Transplant Surgery, Department of Surgery, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - Simon R Knight
- Nuffield Department of Surgical Sciences, Centre for Evidence in Transplantation, University of Oxford, Oxford, UK.,Nuffield Department of Surgical Sciences, University of Oxford, Oxford, UK
| | - Arne P Neyrinck
- Department of Cardiovascular Sciences, Anesthesiology and Algology, KU Leuven, Leuven, Belgium.,Department of Anesthesiology, University Hospitals Leuven, Leuven, Belgium
| | - David Paredes
- Donation and Transplant Coordination Unit, Hospital Clínic, University of Barcelona, Barcelona, Spain
| | - Christopher J E Watson
- Department of Surgery, Addenbrooke's Hospital, University of Cambridge, Cambridge, UK.,The NIHR Cambridge Biomedical Research Centre, Cambridge, UK
| | - Filip Rega
- Department of Cardiovascular Sciences, Cardiac Surgery, KU Leuven, Leuven, Belgium.,Department of Cardiac Surgery, University Hospitals Leuven, Leuven, Belgium
| | - Ina Jochmans
- Transplantation Research Group, Department of Microbiology, Immunology, and Transplantation, KU Leuven, Leuven, Belgium.,Department of Abdominal Transplant Surgery, University Hospitals Leuven, Leuven, Belgium
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13
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Jansen N, Maple H, Forsberg A, Loud F, McColaugh L, Murphy M, Fuertes J, Gallego D, Paredes D. Building a bridge between patients and transplant healthcare professionals - a descriptive study. Transpl Int 2021; 34:2098-2105. [PMID: 34525242 DOI: 10.1111/tri.14111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Revised: 08/26/2021] [Accepted: 08/27/2021] [Indexed: 11/27/2022]
Abstract
This article describes a pathway for collaboration between transplant healthcare professionals and organ recipients. Under the umbrella of the European Society for Organ Transplantation (ESOT) a joint initiative started from three Sections and Committees of ESOT: EDTCO (European Donation and Transplant Coordination Organisation), ETHAP (European Transplant Allied Healthcare Professionals) and ELPAT (Ethical, Legal and Psycho-social Aspects of Transplantation). The formal 'kick-off' of the Advisory Board Meeting of the European Transplant Patient Organisation (ETPO) was during the ESOT congress in 2019. The aim was to produce a series of statements to serve as a path to dialogue between patients and transplant professionals and to define the next steps towards giving a voice to the patient network. To include the patients' perspectives, two surveys have been performed. The results identified the unmet needs and lead to a proposal for future plans. Educational activities have since started leading to a patient learning workstream. All initiatives taken have one purpose: to include patients, give them a voice and build a foundation for collaboration between patients and transplant professionals. ESOT has created a platform for mutual understanding, learning and a collaborative partnership between ETPO and European donation and transplant professionals.
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Affiliation(s)
- Nichon Jansen
- Dutch Transplant Foundation, Leiden, The Netherlands.,European Donation and Transplantation Coordination Organisation (EDTCO), A Section of the European Society for Organ Transplantation, Padua, Italy.,Department of Transplantation, Guy's and St. Thomas' NHS Foundation Trust, London, UK
| | - Hannah Maple
- European Donation and Transplantation Coordination Organisation (EDTCO), A Section of the European Society for Organ Transplantation, Padua, Italy.,Department of Transplantation, Guy's and St. Thomas' NHS Foundation Trust, London, UK.,Ethical, Legal, and Psychosocial Aspects of Transplantation (ELPAT), A Section of the European Society for Organ Transplantation, Padua, Italy
| | - Anna Forsberg
- Department of Health Sciences, Lund University, Lund, Sweden.,Institute of Health Sciences at Lund University, Lund, Sweden.,Department of Cardiothoracic Surgery, Skane University Hospital, Lund University, Lund, Sweden.,European Transplant Allied Healthcare Professionals (ETAHP), A Section of the European Society for Organ Transplantation, Padua, Italy
| | | | | | - Mark Murphy
- CEO Irish Kidney Association, Dublin, Ireland
| | | | | | - David Paredes
- Donation and Transplant Coordination Unit, Associate Professor Surgical Department, Hospital Clinic, University of Barcelona, Barcelona, Spain.,European Donation and Transplantation Coordination Organisation (EDTCO), A Section of the European Society for Organ Transplantation, Padua, Italy
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14
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Jochmans I, Hessheimer AJ, Neyrinck AP, Paredes D, Bellini MI, Dark JH, Kimenai HJAN, Pengel LHM, Watson CJE. Consensus statement on normothermic regional perfusion in donation after circulatory death: report from the European Society for Organ Transplantation's Transplant Learning Journey. Transpl Int 2021; 34:2019-2030. [PMID: 34145644 DOI: 10.1111/tri.13951] [Citation(s) in RCA: 35] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Revised: 06/08/2021] [Accepted: 06/09/2021] [Indexed: 11/27/2022]
Abstract
Normothermic regional perfusion (NRP) in donation after circulatory death (DCD) is a safe alternative to in situ cooling and rapid procurement. An increasing number of countries and centres are performing NRP, a technically and logistically challenging procedure. This consensus document provides evidence-based recommendations on the use of NRP in uncontrolled and controlled DCDs. It also offers minimal ethical, logistical and technical requirements that form the foundation of a safe and effective NRP programme. The present article is based on evidence and opinions formulated by a panel of European experts of Workstream 04 of the Transplantation Learning Journey project, which is part of the European Society for Organ Transplantation.
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Affiliation(s)
- Ina Jochmans
- Transplantation Research Group, Department of Microbiology, Immunology, and Transplantation, KU Leuven, Leuven, Belgium.,Department of Abdominal Transplant Surgery, University Hospitals Leuven, Leuven, Belgium
| | - Amelia J Hessheimer
- Department of General & Digestive Surgery, Institut Clínic de Malalties Digestives i Metabòliques (ICMDM), Hospital Clínic, IDIBAPS, CIBERehd, University of Barcelona, Barcelona, Spain
| | - Arne P Neyrinck
- Anesthesiology and Algology, Department of Cardiovascular Sciences, KU Leuven, Leuven, Belgium.,Department of Anesthesiology, University Hospitals Leuven, Leuven, Belgium
| | - David Paredes
- Donation and Transplant Coordination Unit, Hospital Clínic Barcelona, University of Barcelona, Barcelona, Spain
| | - Maria Irene Bellini
- Department of Emergency Medicine and Surgery, Azienda Ospedaliera San Camillo Forlanini, Rome, Italy
| | - John H Dark
- Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Newcastle, UK
| | - Hendrikus J A N Kimenai
- Division of Transplant Surgery, Department of Surgery, Erasmus MC University Medical Center, Rotterdam, the Netherlands
| | - Liset H M Pengel
- Centre for Evidence in Transplantation, Nuffield Department of Surgical Sciences, University of Oxford, Oxford, UK
| | - Christopher J E Watson
- University of Cambridge, Department of Surgery, Addenbrooke's Hospital, NIHR Cambridge Biomedical Research Centre, Cambridge, UK
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15
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Menjivar A, Torres X, Manyalich M, Fehrman-Ekholm I, Papachristou C, de Sousa-Amorim E, Paredes D, Hiesse C, Yucetin L, Oppenheimer F, Kondi E, Peri JM, Kvarnström N, Ballesté C, Dias L, Frade IC, Lopes A, Diekmann F, Revuelta I. Psychosocial risk factors for impaired health-related quality of life in living kidney donors: results from the ELIPSY prospective study. Sci Rep 2020; 10:21343. [PMID: 33288792 PMCID: PMC7721886 DOI: 10.1038/s41598-020-78032-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Accepted: 11/06/2020] [Indexed: 01/10/2023] Open
Abstract
Living kidney donors' follow-up is usually focused on the assessment of the surgical and medical outcomes. Whilst the psychosocial follow-up is advocated in literature. It is still not entirely clear which exact psychosocial factors are related to a poor psychosocial outcome of donors. The aim of our study is to prospectively assess the donors' psychosocial risks factors to impaired health-related quality of life at 1-year post-donation and link their psychosocial profile before donation with their respective outcomes. The influence of the recipient's medical outcomes on their donor's psychosocial outcome was also examined. Sixty donors completed a battery of standardized psychometric instruments (quality of life, mental health, coping strategies, personality, socio-economic status), and ad hoc items regarding the donation process (e.g., motivations for donation, decision-making, risk assessment, and donor-recipient relationship). Donors' 1-year psychosocial follow-up was favorable and comparable with the general population. So far, cluster-analysis identified a subgroup of donors (28%) with a post-donation reduction of their health-related quality of life. This subgroup expressed comparatively to the rest, the need for more pre-donation information regarding surgery risks, and elevated fear of losing the recipient and commitment to stop their suffering.
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Affiliation(s)
- Ana Menjivar
- Medical School, University of Barcelona, Barcelona, Spain.,Laboratori Experimental de Nefrologia I Trasplantament (LENIT), Institut d'Investigacions Biomediques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Xavier Torres
- Psychiatry and Clinical Psychology Service, Institut Clinic de Neurociencies, Hospital Clinic of Barcelona, Barcelona, Spain
| | - Marti Manyalich
- Medical School, University of Barcelona, Barcelona, Spain.,Transplant Assessorial Unit, Medical Direction, Hospital Clinic of Barcelona, Barcelona, Spain
| | - Ingela Fehrman-Ekholm
- Karolinska Institutet, Transplantation Surgery, Karolinska University Hospital, Stockholm, Sweden
| | - Christina Papachristou
- Department for Internal Medicine and Psychosomatics, Charité, University Medicine, Berlin, Germany.,School of Psychology, Aristotle University of Thessaloniki, Thessaloníki, Greece
| | - Erika de Sousa-Amorim
- Department of Nephrology and Renal Transplant, Hospital Clinic of Barcelona, Barcelona, Spain
| | - David Paredes
- Medical School, University of Barcelona, Barcelona, Spain.,Donation and Transplant Coordination Section, Hospital Clinic of Barcelona, Barcelona, Spain
| | - Christian Hiesse
- Service de Néphrologie et de Transplantation Rénale, Hôpital Foch, Suresnes Cedex, France
| | - Levent Yucetin
- Organ Transplant Coordination, Antalya Medical Park Hospital, Antalya, Turkey
| | - Federico Oppenheimer
- Laboratori Experimental de Nefrologia I Trasplantament (LENIT), Institut d'Investigacions Biomediques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.,Department of Nephrology and Renal Transplant, Hospital Clinic of Barcelona, Barcelona, Spain
| | - Entela Kondi
- Medical School, University of Barcelona, Barcelona, Spain.,Transplant Assessorial Unit, Medical Direction, Hospital Clinic of Barcelona, Barcelona, Spain
| | - Josep Maria Peri
- Psychiatry and Clinical Psychology Service, Institut Clinic de Neurociencies, Hospital Clinic of Barcelona, Barcelona, Spain
| | - Niclas Kvarnström
- Department of Transplantation, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Chloë Ballesté
- Medical School, University of Barcelona, Barcelona, Spain
| | - Leonidio Dias
- Nephrology and Transplant Departments, Hospital Geral de Santo António, Porto, Portugal
| | - Inês C Frade
- Liaison-Psychiatry and Health Psychology Unit, Hospital Geral de Santo António, Porto, Portugal
| | - Alice Lopes
- Liaison-Psychiatry and Health Psychology Unit, Hospital Geral de Santo António, Porto, Portugal
| | - Fritz Diekmann
- Laboratori Experimental de Nefrologia I Trasplantament (LENIT), Institut d'Investigacions Biomediques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.,Department of Nephrology and Renal Transplant, Hospital Clinic of Barcelona, Barcelona, Spain
| | - Ignacio Revuelta
- Medical School, University of Barcelona, Barcelona, Spain. .,Laboratori Experimental de Nefrologia I Trasplantament (LENIT), Institut d'Investigacions Biomediques August Pi i Sunyer (IDIBAPS), Barcelona, Spain. .,Department of Nephrology and Renal Transplant, Hospital Clinic of Barcelona, Barcelona, Spain.
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16
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Musquera M, Sierra A, Diekmann F, Perez M, Mercader C, Peri L, Esforzado N, Paredes D, Alcaraz A. Increasing kidney grafts for transplantation. World J Urol 2020; 39:2795-2800. [PMID: 33000340 DOI: 10.1007/s00345-020-03463-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2020] [Accepted: 09/18/2020] [Indexed: 11/28/2022] Open
Abstract
INTRODUCTION The current pool of organs available for transplantation does not cover requirements, for this reason non-standard risk donors need to be incorporated into the pool. In this way, donors with small renal tumour are considered for transplantation after bench tumour excision. The aim of our study was to analyse our experience in using these grafts for transplantation. MATERIALS AND METHODS Retrospective analysis from our prospective accrued database of donors with incidental renal mass used for kidney transplantation between January 2007 and August 2018. RESULTS Twenty kidney transplantations were performed, thirteen cases received the affected kidney (after tumour removal) and seven the contralateral kidney; from six living and eleven deceased donors. Donor and recipient median age was 58 years (range 22-82) and 56.5 years (range 38-74), respectively. Mean tumour diameter was 12.7 mm (SD 9.5). Tumours resulted in two benign lesions and fifteen renal cell carcinoma. Surgical margins were negative. Two cases presented with bleeding after reperfusion was solved without repercussion. One case presented with immediate vein thrombosis. None of them present delayed graft function. After a 69 month follow-up none of the donors or the recipients presented tumour recurrence. CONCLUSIONS Kidneys with small incidental tumours seem to be a good option for kidney transplantation in selected patients after bench surgery excision with good functional and oncologic results. More studies and longer follow-up are needed to confirm these results.
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Affiliation(s)
- Mireia Musquera
- Hospital Clinic de Barcelona, Instituto Clínic de Nefrología y Urología, Urology, Villarroel 170, 08036, Barcelona, Spain.
| | - Alba Sierra
- Hospital Clinic de Barcelona, Instituto Clínic de Nefrología y Urología, Urology, Villarroel 170, 08036, Barcelona, Spain
| | - Fritz Diekmann
- Hospital Clinic de Barcelona, Instituto Clínic de Nefrología y Urología, Nefrology, Villarroel 170, 08036, Barcelona, Spain
| | - Meritxell Perez
- Hospital de Terrassa. Torrebonica, s/n, 08227 Terrassa, Barcelona, Spain
| | | | - Lluis Peri
- Hospital Clinic de Barcelona, Instituto Clínic de Nefrología y Urología, Urology, Villarroel 170, 08036, Barcelona, Spain
| | - Nuria Esforzado
- Hospital Clinic de Barcelona, Instituto Clínic de Nefrología y Urología, Nefrology, Villarroel 170, 08036, Barcelona, Spain
| | - David Paredes
- Hospital Clinic de Barcelona, Coordination Unit, Villarroel 170 Barcelona, 08036, Catalunya, Spain
| | - Antonio Alcaraz
- Hospital Clinic de Barcelona, Instituto Clínic de Nefrología y Urología, Urology, Villarroel 170, 08036, Barcelona, Spain
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17
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Fassler DJ, Abousamra S, Gupta R, Chen C, Zhao M, Paredes D, Batool SA, Knudsen BS, Escobar-Hoyos L, Shroyer KR, Samaras D, Kurc T, Saltz J. Publisher Correction to: Deep learning-based image analysis methods for brightfield-acquired multiplex immunohistochemistry images. Diagn Pathol 2020; 15:116. [PMID: 32972449 PMCID: PMC7513292 DOI: 10.1186/s13000-020-01021-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Affiliation(s)
- Danielle J Fassler
- Department of Pathology, Stony Brook University Renaissance School of Medicine, 101 Nicolls Rd, Stony Brook, 11794, USA
| | - Shahira Abousamra
- Department of Computer Science, Stony Brook University, 100 Nicolls Rd, Stony Brook, 11794, USA
| | - Rajarsi Gupta
- Department of Biomedical Informatics, Stony Brook University Renaissance School of Medicine, 101 Nicolls Rd, Stony Brook, 11794, USA
| | - Chao Chen
- Department of Biomedical Informatics, Stony Brook University Renaissance School of Medicine, 101 Nicolls Rd, Stony Brook, 11794, USA
| | - Maozheng Zhao
- Department of Computer Science, Stony Brook University, 100 Nicolls Rd, Stony Brook, 11794, USA
| | - David Paredes
- Department of Computer Science, Stony Brook University, 100 Nicolls Rd, Stony Brook, 11794, USA
| | - Syeda Areeha Batool
- Department of Biomedical Informatics, Stony Brook University Renaissance School of Medicine, 101 Nicolls Rd, Stony Brook, 11794, USA
| | - Beatrice S Knudsen
- Department of Pathology, University of Utah, 2000 Circle of Hope, Salt Lake City, UT, 84112, USA
| | - Luisa Escobar-Hoyos
- Department of Pathology, Stony Brook University Renaissance School of Medicine, 101 Nicolls Rd, Stony Brook, 11794, USA.,Department Therapeutic Radiology, Yale University, 15 York Street, New Haven, CT, 06513, USA
| | - Kenneth R Shroyer
- Department of Pathology, Stony Brook University Renaissance School of Medicine, 101 Nicolls Rd, Stony Brook, 11794, USA
| | - Dimitris Samaras
- Department of Computer Science, Stony Brook University, 100 Nicolls Rd, Stony Brook, 11794, USA
| | - Tahsin Kurc
- Department of Biomedical Informatics, Stony Brook University Renaissance School of Medicine, 101 Nicolls Rd, Stony Brook, 11794, USA
| | - Joel Saltz
- Department of Biomedical Informatics, Stony Brook University Renaissance School of Medicine, 101 Nicolls Rd, Stony Brook, 11794, USA.
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18
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Fassler DJ, Abousamra S, Gupta R, Chen C, Zhao M, Paredes D, Batool SA, Knudsen BS, Escobar-Hoyos L, Shroyer KR, Samaras D, Kurc T, Saltz J. Deep learning-based image analysis methods for brightfield-acquired multiplex immunohistochemistry images. Diagn Pathol 2020; 15:100. [PMID: 32723384 PMCID: PMC7385962 DOI: 10.1186/s13000-020-01003-0] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2019] [Accepted: 07/12/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Multiplex immunohistochemistry (mIHC) permits the labeling of six or more distinct cell types within a single histologic tissue section. The classification of each cell type requires detection of the unique colored chromogens localized to cells expressing biomarkers of interest. The most comprehensive and reproducible method to evaluate such slides is to employ digital pathology and image analysis pipelines to whole-slide images (WSIs). Our suite of deep learning tools quantitatively evaluates the expression of six biomarkers in mIHC WSIs. These methods address the current lack of readily available methods to evaluate more than four biomarkers and circumvent the need for specialized instrumentation to spectrally separate different colors. The use case application for our methods is a study that investigates tumor immune interactions in pancreatic ductal adenocarcinoma (PDAC) with a customized mIHC panel. METHODS Six different colored chromogens were utilized to label T-cells (CD3, CD4, CD8), B-cells (CD20), macrophages (CD16), and tumor cells (K17) in formalin-fixed paraffin-embedded (FFPE) PDAC tissue sections. We leveraged pathologist annotations to develop complementary deep learning-based methods: (1) ColorAE is a deep autoencoder which segments stained objects based on color; (2) U-Net is a convolutional neural network (CNN) trained to segment cells based on color, texture and shape; and ensemble methods that employ both ColorAE and U-Net, collectively referred to as (3) ColorAE:U-Net. We assessed the performance of our methods using: structural similarity and DICE score to evaluate segmentation results of ColorAE against traditional color deconvolution; F1 score, sensitivity, positive predictive value, and DICE score to evaluate the predictions from ColorAE, U-Net, and ColorAE:U-Net ensemble methods against pathologist-generated ground truth. We then used prediction results for spatial analysis (nearest neighbor). RESULTS We observed that (1) the performance of ColorAE is comparable to traditional color deconvolution for single-stain IHC images (note: traditional color deconvolution cannot be used for mIHC); (2) ColorAE and U-Net are complementary methods that detect 6 different classes of cells with comparable performance; (3) combinations of ColorAE and U-Net into ensemble methods outperform using either ColorAE and U-Net alone; and (4) ColorAE:U-Net ensemble methods can be employed for detailed analysis of the tumor microenvironment (TME). We developed a suite of scalable deep learning methods to analyze 6 distinctly labeled cell populations in mIHC WSIs. We evaluated our methods and found that they reliably detected and classified cells in the PDAC tumor microenvironment. We also present a use case, wherein we apply the ColorAE:U-Net ensemble method across 3 mIHC WSIs and use the predictions to quantify all stained cell populations and perform nearest neighbor spatial analysis. Thus, we provide proof of concept that these methods can be employed to quantitatively describe the spatial distribution immune cells within the tumor microenvironment. These complementary deep learning methods are readily deployable for use in clinical research studies.
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Affiliation(s)
- Danielle J Fassler
- Department of Pathology, Stony Brook University Renaissance School of Medicine, 101 Nicolls Rd, Stony Brook, 11794, USA
| | - Shahira Abousamra
- Department of Computer Science, Stony Brook University, 100 Nicolls Rd, Stony Brook, 11794, USA
| | - Rajarsi Gupta
- Department of Biomedical Informatics, Stony Brook University Renaissance School of Medicine, 101 Nicolls Rd, Stony Brook, 11794, USA
| | - Chao Chen
- Department of Biomedical Informatics, Stony Brook University Renaissance School of Medicine, 101 Nicolls Rd, Stony Brook, 11794, USA
| | - Maozheng Zhao
- Department of Computer Science, Stony Brook University, 100 Nicolls Rd, Stony Brook, 11794, USA
| | - David Paredes
- Department of Computer Science, Stony Brook University, 100 Nicolls Rd, Stony Brook, 11794, USA
| | - Syeda Areeha Batool
- Department of Biomedical Informatics, Stony Brook University Renaissance School of Medicine, 101 Nicolls Rd, Stony Brook, 11794, USA
| | - Beatrice S Knudsen
- Department of Pathology, University of Utah, 2000 Circle of Hope, Salt Lake City, UT, 84112, USA
| | - Luisa Escobar-Hoyos
- Department of Pathology, Stony Brook University Renaissance School of Medicine, 101 Nicolls Rd, Stony Brook, 11794, USA
- Department Therapeutic Radiology, Yale University, 15 York Street, New Haven, CT, 06513, USA
| | - Kenneth R Shroyer
- Department of Pathology, Stony Brook University Renaissance School of Medicine, 101 Nicolls Rd, Stony Brook, 11794, USA
| | - Dimitris Samaras
- Department of Computer Science, Stony Brook University, 100 Nicolls Rd, Stony Brook, 11794, USA
| | - Tahsin Kurc
- Department of Biomedical Informatics, Stony Brook University Renaissance School of Medicine, 101 Nicolls Rd, Stony Brook, 11794, USA
| | - Joel Saltz
- Department of Biomedical Informatics, Stony Brook University Renaissance School of Medicine, 101 Nicolls Rd, Stony Brook, 11794, USA.
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Gelpi R, Paredes D, Rodríguez-Villar C, Roque R, Ruiz A, Adalia R, Peri-Cusí L, Sole M, Oppenheimer F, Diekmann F. The development of a predictive model of graft function in uncontrolled donors after circulatory death: validity of a pulsatile renal preservation machine cut-off value for kidney acceptance. Nephrol Dial Transplant 2019; 34:531-538. [PMID: 30085267 DOI: 10.1093/ndt/gfy241] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2017] [Accepted: 06/14/2018] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND The criteria for kidney suitability in uncontrolled donors after circulatory death (uDCD) procured after regional normothermic perfusion are based on macroscopic appearance and renal haemodynamic values with final renal resistance (FRR). However, these criteria have not been analysed to predict the future graft function. This study presents a model to predict the outcome in uDCD kidneys and define the predictive FRR value. METHODS All uDCD kidney transplants performed in our hospital from 2004 to 2016 were included. Donors and recipients and pre-transplantation data are described. The endpoint was glomerular filtration rate (GFR) ≥30 mL/min at 6 months after transplantation. RESULTS A total of 194 recipients were included. FRR in donors ≥60 years old was (mean ± SD) 0.27 ± 0.11 versus 0.22 ± 0.09 mmHg/mL/min in donors <60 years (P = 0.042). Kidney survival was 88.2% versus 84% at 12 months and 60.7% versus 30.8% at 120 months (P = 0.067). For the group of recipients from donors ≥60 years, the FRR was 0.37 ± 0.08 mmHg/mL/min in the GFR <30 mL/min group versus 0.18 ± 0.06 mmHg/mL/min in the GFR ≥30 mL/min group (P < 0.001). The value FRR ≥0.3 mmHg/mL/min predicts 59-79% of GFR <30 mL/min [odds ratio = 2.16, 95% confidence interval (CI) 1.80-6.40; P < 0.001]. The predictive accuracy of FRR for GFR by ROC curve was 0.968 (95% CI). The best cut-off for FRR was 0.3 mmHg/mL/min to predict GFR at 6 months with a sensitivity of 67%, specificity of 100%, positive predictive value of 83% and negative predictive value of 92%. CONCLUSIONS Our results suggest that in uDCD donors the combination of donor age ≥60 years together with FRR ≥0.3 mmHg/mL/min could predict poor outcome at 6 months after transplantation in low immunological risk recipients.
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Affiliation(s)
- Rosana Gelpi
- Nephrology and Renal Transplant Department, Donation and Transplant Coordination Department, Hospital Clínic i Universitari de Barcelona, Barcelona, Spain
| | - David Paredes
- Nephrology and Renal Transplant Department, Donation and Transplant Coordination Department, Hospital Clínic i Universitari de Barcelona, Barcelona, Spain
| | - Camino Rodríguez-Villar
- Nephrology and Renal Transplant Department, Donation and Transplant Coordination Department, Hospital Clínic i Universitari de Barcelona, Barcelona, Spain
| | - Rebeca Roque
- Nephrology and Renal Transplant Department, Donation and Transplant Coordination Department, Hospital Clínic i Universitari de Barcelona, Barcelona, Spain
| | - Angel Ruiz
- Nephrology and Renal Transplant Department, Donation and Transplant Coordination Department, Hospital Clínic i Universitari de Barcelona, Barcelona, Spain
| | - Ramon Adalia
- Nephrology and Renal Transplant Department, Donation and Transplant Coordination Department, Hospital Clínic i Universitari de Barcelona, Barcelona, Spain
| | - Luis Peri-Cusí
- Nephrology and Renal Transplant Department, Donation and Transplant Coordination Department, Hospital Clínic i Universitari de Barcelona, Barcelona, Spain
| | - Manel Sole
- Nephrology and Renal Transplant Department, Donation and Transplant Coordination Department, Hospital Clínic i Universitari de Barcelona, Barcelona, Spain
| | - Federico Oppenheimer
- Nephrology and Renal Transplant Department, Donation and Transplant Coordination Department, Hospital Clínic i Universitari de Barcelona, Barcelona, Spain
| | - Fritz Diekmann
- Nephrology and Renal Transplant Department, Donation and Transplant Coordination Department, Hospital Clínic i Universitari de Barcelona, Barcelona, Spain
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20
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Villafuerte-Ledesma HM, De Sousa-Amorim E, Peri L, Musquera M, Palou E, Lozano M, Cid J, Martorell J, Paredes D, Cucchiari D, Ventura-Aguiar P, Campistol JM, Alcaraz A, Oppenheimer F, Diekmann F, Revuelta I. Impact of Discards for Living Donor Kidney Transplantation in a Transplant Program. Transplant Proc 2019; 51:3222-3226. [PMID: 31732206 DOI: 10.1016/j.transproceed.2019.09.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2019] [Accepted: 09/26/2019] [Indexed: 11/19/2022]
Abstract
OBJECTIVE Living donor kidney transplantation (LDKT) is the best treatment for end-stage renal disease. In this setting, a significant percentage of transplants are not undertaken because of medical and nonmedical reasons of both donors and recipients. However, the impact of these discards in a transplant program has not been identified thoroughly so far. Our objective was to clarify key reasons for exclusion of LDKTs and the consequences for the discarded transplant candidates in the following 5 years. METHODS Analysis of donors' and recipients' characteristics of 781 couples evaluated in our hospital from January 2005 to December 2013. The consequences of discards in transplant candidates were analyzed in the cohort 2012 to 2013 (n = 106) and followed up until October 2018. RESULTS In our study group, 402 (51.5%) LDKT couples were successfully donated, and 379 (48.5%) were excluded. Donor and transplant recipient candidates discarded were older at the evaluation (55.07 ± 12.14 years vs 51.73 ± 10.93 years, P < .001; 48.81 ± 14.05 years vs 44.62 ± 13.91 years, P < .001, respectively). The most frequent reason for kidney discard was medical contraindication found in the potential donor (47.5%; low eGFR, diabetes mellitus, impaired glucose tolerance, high blood pressure, cardiovascular pathology casually found during evaluation, and proteinuria). Of the discarded candidates from 2012 to 2013, 36.8% received a deceased donor kidney transplant, 17% a LDKT with another donor, 7.5% stayed on the waiting list, 18.9% died, 3.8% were excluded from the waiting list, and 14.2% were lost to follow-up. CONCLUSIONS In most cases, transplantation was not undertaken because of donor pathology. Fifty-three percent of the discarded patients were eventually transplanted, with a 31.4% probability to receive an organ from another living donor.
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Affiliation(s)
- Hilda M Villafuerte-Ledesma
- Nephrology and Renal Transplant Department, Hospital Clinic, Universitat de Barcelona, Barcelona, Spain; Nephrology Department, Hospital Clínico Lozano Blesa, Zaragoza, Spain
| | - Erika De Sousa-Amorim
- Nephrology and Renal Transplant Department, Hospital Clinic, Universitat de Barcelona, Barcelona, Spain; Laboratori Experimental de Nefrologia i Trasplantament (LENIT), IDIBAPS, Barcelona, Spain
| | - Lluis Peri
- Urology Department, Hospital Clinic, Universitat de Barcelona, Barcelona, Spain; Barcelona University, Barcelona, Spain
| | - Mireia Musquera
- Urology Department, Hospital Clinic, Universitat de Barcelona, Barcelona, Spain; Barcelona University, Barcelona, Spain
| | - Eduard Palou
- Immunology Department, Hospital Clinic, Barcelona, Spain
| | - Miquel Lozano
- Barcelona University, Barcelona, Spain; Apheresis and Cellular Therapy Unit, Hospital Clinic, Barcelona, Spain
| | - Joan Cid
- Barcelona University, Barcelona, Spain; Apheresis and Cellular Therapy Unit, Hospital Clinic, Barcelona, Spain
| | | | - David Paredes
- Barcelona University, Barcelona, Spain; Donation and Transplant Coordination Section, Hospital Clinic, Barcelona, Spain
| | - David Cucchiari
- Nephrology and Renal Transplant Department, Hospital Clinic, Universitat de Barcelona, Barcelona, Spain; Laboratori Experimental de Nefrologia i Trasplantament (LENIT), IDIBAPS, Barcelona, Spain; Spanish Kidney Research Network, ISCIII-RETIC REDinREN RD016/0 009, Madrid, Spain
| | - Pedro Ventura-Aguiar
- Nephrology and Renal Transplant Department, Hospital Clinic, Universitat de Barcelona, Barcelona, Spain; Laboratori Experimental de Nefrologia i Trasplantament (LENIT), IDIBAPS, Barcelona, Spain; Spanish Kidney Research Network, ISCIII-RETIC REDinREN RD016/0 009, Madrid, Spain
| | - Josep M Campistol
- Nephrology and Renal Transplant Department, Hospital Clinic, Universitat de Barcelona, Barcelona, Spain; Laboratori Experimental de Nefrologia i Trasplantament (LENIT), IDIBAPS, Barcelona, Spain; Barcelona University, Barcelona, Spain; Spanish Kidney Research Network, ISCIII-RETIC REDinREN RD016/0 009, Madrid, Spain
| | - Antonio Alcaraz
- Urology Department, Hospital Clinic, Universitat de Barcelona, Barcelona, Spain; Barcelona University, Barcelona, Spain
| | - Federico Oppenheimer
- Nephrology and Renal Transplant Department, Hospital Clinic, Universitat de Barcelona, Barcelona, Spain; Laboratori Experimental de Nefrologia i Trasplantament (LENIT), IDIBAPS, Barcelona, Spain; Barcelona University, Barcelona, Spain; Spanish Kidney Research Network, ISCIII-RETIC REDinREN RD016/0 009, Madrid, Spain
| | - Fritz Diekmann
- Nephrology and Renal Transplant Department, Hospital Clinic, Universitat de Barcelona, Barcelona, Spain; Laboratori Experimental de Nefrologia i Trasplantament (LENIT), IDIBAPS, Barcelona, Spain; Barcelona University, Barcelona, Spain; Spanish Kidney Research Network, ISCIII-RETIC REDinREN RD016/0 009, Madrid, Spain
| | - Ignacio Revuelta
- Nephrology and Renal Transplant Department, Hospital Clinic, Universitat de Barcelona, Barcelona, Spain; Laboratori Experimental de Nefrologia i Trasplantament (LENIT), IDIBAPS, Barcelona, Spain; Barcelona University, Barcelona, Spain; Spanish Kidney Research Network, ISCIII-RETIC REDinREN RD016/0 009, Madrid, Spain.
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21
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Lenz Alcayaga R, Viviana J, Paredes D, Castro L, García C, Roblero J. PCN40 COSTS OF COMPREHENSIVE CARE OF HEPATOCELLULAR CARCINOMA IN A MODEL PUBLIC PROVIDER IN CHILE: IS IT POSSIBLE TO PROMOTE FINANCIAL COVERAGE? Value Health Reg Issues 2019. [DOI: 10.1016/j.vhri.2019.08.108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Paredes D, Lenz Alcayaga R, Hitschfeld M, Vo P, Carboni V, Quintana R. PND14 OUT-OF-POCKET EXPENDITURE IN MIGRAINE PATIENTS WITH AND WITHOUT COMORBIDITIES IN CHILE: A HEALTHCARE SYSTEM PERSPECTIVE. Value Health Reg Issues 2019. [DOI: 10.1016/j.vhri.2019.08.344] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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23
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Lenz Alcayaga R, Paredes D, Hitschfeld M, Vo P, Quintana R, Carboni V. PND12 WORK PRODUCTIVITY AND DAILY ACTIVITIES IMPAIRMENT (WPAI) IN CHILEAN PATIENTS WITH MIGRAINE: PERSPECTIVES ON INDIRECT-COSTS DRIVERS. Value Health Reg Issues 2019. [DOI: 10.1016/j.vhri.2019.08.342] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Oriol I, Sabe N, Càmara J, Berbel D, Ballesteros MA, Escudero R, Lopez-Medrano F, Linares L, Len O, Silva JT, Oliver E, Soldevila L, Pérez-Recio S, Guillem LL, Camprubí D, LLadó L, Manonelles A, González-Costello J, Domínguez MA, Fariñas MC, Lavid N, González-Rico C, Garcia-Cuello L, Arnaiz de Las Revillas F, Fortun J, Aguado JM, Jimenez-Romero C, Bodro M, Almela M, Paredes D, Moreno A, Pérez-Cameo C, Muñoz-Sanz A, Blanco-Fernández G, Cabo-González JA, García-López JL, Nuño E, Carratalà J. The Impact of Culturing the Organ Preservation Fluid on Solid Organ Transplantation: A Prospective Multicenter Cohort Study. Open Forum Infect Dis 2019; 6:ofz180. [PMID: 31198815 PMCID: PMC6546202 DOI: 10.1093/ofid/ofz180] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2019] [Accepted: 04/17/2019] [Indexed: 01/29/2023] Open
Abstract
Background We analyzed the prevalence, etiology, and risk factors of culture-positive preservation fluid and their impact on the management of solid organ transplant recipients. Methods From July 2015 to March 2017, 622 episodes of adult solid organ transplants at 7 university hospitals in Spain were prospectively included in the study. Results The prevalence of culture-positive preservation fluid was 62.5% (389/622). Nevertheless, in only 25.2% (98/389) of the cases were the isolates considered "high risk" for pathogenicity. After applying a multivariate regression analysis, advanced donor age was the main associated factor for having culture-positive preservation fluid for high-risk microorganisms. Preemptive antibiotic therapy was given to 19.8% (77/389) of the cases. The incidence rate of preservation fluid-related infection was 1.3% (5 recipients); none of these patients had received preemptive therapy. Solid organ transplant (SOT) recipients with high-risk culture-positive preservation fluid receiving preemptive antibiotic therapy presented both a lower cumulative incidence of infection and a lower rate of acute rejection and graft loss compared with those who did not have high-risk culture-positive preservation fluid. After adjusting for age, sex, type of transplant, and prior graft rejection, preemptive antibiotic therapy remained a significant protective factor for 90-day infection. Conclusions The routine culture of preservation fluid may be considered a tool that provides information about the contamination of the transplanted organ. Preemptive therapy for SOT recipients with high-risk culture-positive preservation fluid may be useful to avoid preservation fluid-related infections and improve the outcomes of infection, graft loss, and graft rejection in transplant patients.
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Affiliation(s)
- I Oriol
- Infectious Disease Department, Hospital Universitari de Bellvitge - IDIBELL; L'Hospitalet de Llobregat, Barcelona, Spain.,Spanish Network for Research in Infectious Diseases (REIPI).,Clinical Science Department, Faculty of Medicine, University of Barcelona, Barcelona
| | - N Sabe
- Infectious Disease Department, Hospital Universitari de Bellvitge - IDIBELL; L'Hospitalet de Llobregat, Barcelona, Spain.,Spanish Network for Research in Infectious Diseases (REIPI).,Clinical Science Department, Faculty of Medicine, University of Barcelona, Barcelona
| | - J Càmara
- Microbiology Department, Hospital Universitari de Bellvitge-Universitat de Barcelona-IDIBELL, L'Hospitalet de Llobregat, Spain.,CIBER de Enfermedades Respiratorias (CIBERes), Madrid, Spain
| | - D Berbel
- Microbiology Department, Hospital Universitari de Bellvitge-Universitat de Barcelona-IDIBELL, L'Hospitalet de Llobregat, Spain.,CIBER de Enfermedades Respiratorias (CIBERes), Madrid, Spain
| | - M A Ballesteros
- Intensive Care Unit, Marqués de Valdecilla Hospital, University of Cantabria, IDIVAL, Santander, Spain
| | - R Escudero
- Infectious Diseases Department, Hospital Universitario Ramón y Cajal, Madrid, Spain. IRYCIS
| | - F Lopez-Medrano
- Unit of Infectious Diseases, Hospital Universitario "12 de Octubre", Instituto de Investigación Sanitaria Hospital "12 de Octubre" (imas12), Madrid, Spain.,School of Medicine, Universidad Complutense, Madrid, Spain
| | - L Linares
- Clinical Science Department, Faculty of Medicine, University of Barcelona, Barcelona.,Infectious Diseases Department, Hospital Clínic-IDIBAPS, Barcelona, Spain
| | - O Len
- Infectious Diseases Department, Hospital Universitari Vall d'Hebron, Barcelona, Spain.,Universitat Autònoma de Barcelona, Barcelona, Spain
| | - J T Silva
- Unit of Infectious Diseases, Hospital Universitario "12 de Octubre", Instituto de Investigación Sanitaria Hospital "12 de Octubre" (imas12), Madrid, Spain.,School of Medicine, Universidad Complutense, Madrid, Spain.,Department of Infectious Diseases, Hospital Universitario de Badajoz, Spain
| | - E Oliver
- Donor Coordination Unit, Bellvitge University Hospital, Barcelona, Spain
| | - L Soldevila
- Infectious Disease Department, Hospital Universitari de Bellvitge - IDIBELL; L'Hospitalet de Llobregat, Barcelona, Spain
| | - S Pérez-Recio
- Infectious Disease Department, Hospital Universitari de Bellvitge - IDIBELL; L'Hospitalet de Llobregat, Barcelona, Spain
| | - L L Guillem
- Infectious Disease Department, Hospital Universitari de Bellvitge - IDIBELL; L'Hospitalet de Llobregat, Barcelona, Spain
| | - D Camprubí
- Infectious Disease Department, Hospital Universitari de Bellvitge - IDIBELL; L'Hospitalet de Llobregat, Barcelona, Spain
| | - L LLadó
- Liver Transplant Unit, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat (Barcelona), Spain
| | - A Manonelles
- Department of Nephrology, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat (Barcelona), Spain
| | - J González-Costello
- Department of Cardiology, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat (Barcelona), Spain
| | - M A Domínguez
- Spanish Network for Research in Infectious Diseases (REIPI).,Microbiology Department, Hospital Universitari de Bellvitge-Universitat de Barcelona-IDIBELL, L'Hospitalet de Llobregat, Spain.,Department of Pathology and Experimental Therapeutics, Faculty of Medicine and Health Sciences, University of Barcelona, Barcelona
| | - M C Fariñas
- Infectious Diseases Unit, Marqués de Valdecilla Hospital, University of Cantabria, IDIVAL, Santander, Spain
| | - N Lavid
- Donor Coordination Unit, Marqués de Valdecilla Hospital, University of Cantabria, IDIVAL, Santander, Spain
| | - C González-Rico
- Infectious Diseases Unit, Marqués de Valdecilla Hospital, University of Cantabria, IDIVAL, Santander, Spain
| | - L Garcia-Cuello
- Infectious Diseases Unit, Marqués de Valdecilla Hospital, University of Cantabria, IDIVAL, Santander, Spain
| | - F Arnaiz de Las Revillas
- Infectious Diseases Unit, Marqués de Valdecilla Hospital, University of Cantabria, IDIVAL, Santander, Spain
| | - J Fortun
- Infectious Diseases Department, Hospital Universitario Ramón y Cajal, Madrid, Spain. IRYCIS
| | - J M Aguado
- Unit of Infectious Diseases, Hospital Universitario "12 de Octubre", Instituto de Investigación Sanitaria Hospital "12 de Octubre" (imas12), Madrid, Spain.,School of Medicine, Universidad Complutense, Madrid, Spain
| | - C Jimenez-Romero
- Unit of Infectious Diseases, Hospital Universitario "12 de Octubre", Instituto de Investigación Sanitaria Hospital "12 de Octubre" (imas12), Madrid, Spain.,School of Medicine, Universidad Complutense, Madrid, Spain
| | - M Bodro
- Clinical Science Department, Faculty of Medicine, University of Barcelona, Barcelona.,Infectious Diseases Department, Hospital Clínic-IDIBAPS, Barcelona, Spain
| | - M Almela
- Clinical Science Department, Faculty of Medicine, University of Barcelona, Barcelona.,Infectious Diseases Department, Hospital Clínic-IDIBAPS, Barcelona, Spain
| | - D Paredes
- Clinical Science Department, Faculty of Medicine, University of Barcelona, Barcelona.,Infectious Diseases Department, Hospital Clínic-IDIBAPS, Barcelona, Spain
| | - A Moreno
- Clinical Science Department, Faculty of Medicine, University of Barcelona, Barcelona.,Infectious Diseases Department, Hospital Clínic-IDIBAPS, Barcelona, Spain
| | - C Pérez-Cameo
- Universitat Autònoma de Barcelona, Barcelona, Spain.,Department of Internal Medicine, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - A Muñoz-Sanz
- Department of Infectious Diseases, Hospital Universitario de Badajoz, Spain
| | | | | | - J L García-López
- Donor Coordination Unit, Hospital universitario de Badajoz, Spain
| | - E Nuño
- Donor Coordination Unit, Hospital universitario de Badajoz, Spain
| | - J Carratalà
- Infectious Disease Department, Hospital Universitari de Bellvitge - IDIBELL; L'Hospitalet de Llobregat, Barcelona, Spain.,Spanish Network for Research in Infectious Diseases (REIPI).,Clinical Science Department, Faculty of Medicine, University of Barcelona, Barcelona
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Gómez-Junyent J, Paredes D, Hurtado JC, Requena-Méndez A, Ruiz A, Valls ME, Vila J, Muñoz J. High seroprevalence of Strongyloides stercoralis among individuals from endemic areas considered for solid organ transplant donation: A retrospective serum-bank based study. PLoS Negl Trop Dis 2018; 12:e0007010. [PMID: 30496174 PMCID: PMC6289465 DOI: 10.1371/journal.pntd.0007010] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2018] [Revised: 12/11/2018] [Accepted: 11/19/2018] [Indexed: 11/18/2022] Open
Abstract
Background Strongyloides stercoralis is a worldwide disseminated parasitic disease that can be transmitted from solid organ transplant (SOT) donors to recipients. We determined the serological prevalence of S. stercoralis among deceased individuals from endemic areas considered for SOT donation, using our institution’s serum bank. Methodology Retrospective study including all deceased potential donors from endemic areas of strongyloidiasis considered for SOT between January 2004 and December 2014 in a tertiary care hospital. The commercial serological test IVD-Elisa was used to determine the serological prevalence of S. stercoralis. Principal findings Among 1025 deceased individuals during the study period, 90 were from endemic areas of strongyloidiasis. There were available serum samples for 65 patients and 6 of them tested positive for S. stercoralis (9.23%). Only one of the deceased candidates was finally a donor, without transmitting the infection. Conclusions Among deceased individuals from endemic areas considered for SOT donation, seroprevalence of strongyloidiasis was high. This highlights the importance of adhering to current recommendations on screening for S. stercoralis among potential SOT donors at high risk of the infection, together with the need of developing a rapid diagnostic test to fully implement these screening strategies. Strongyloidiasis is a neglected tropical disease caused by a parasite which is endemic in most parts of the world. It can cause a life-threatening disease among immunosuppressed individuals and can be transmitted from solid organ transplant donors to recipients. We retrospectively investigated the prevalence of strongyloidiasis among deceased individuals from endemic areas who were considered for solid organ transplant donation in our center, by performing a serological assay using our institution’s serum bank. We found a high prevalence of strongyloidiasis among these deceased candidates to donation, but only one of the six who tested positive was finally a donor, without transmitting the disease to recipients. Our results should encourage physicians to adhere to current guidelines which recommend active screening of strongyloidiasis in potential solid organ transplant donors from endemic areas who may be infected. There is a clear need for a rapid diagnostic test to fully implement systematic screening among these individuals.
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Affiliation(s)
- Joan Gómez-Junyent
- ISGlobal, Barcelona Ctr. Int. Health Res. (CRESIB), Hospital Clínic—Universitat de Barcelona, Barcelona, Spain
- * E-mail:
| | - David Paredes
- Donation and Transplant Coordination Section, Hospital Clínic–Universitat de Barcelona, Barcelona, Spain
| | - Juan Carlos Hurtado
- Department of Clinical Microbiology, Centre for Biomedical Diagnosis, Hospital Clínic, Barcelona, Spain
| | - Ana Requena-Méndez
- ISGlobal, Barcelona Ctr. Int. Health Res. (CRESIB), Hospital Clínic—Universitat de Barcelona, Barcelona, Spain
| | - Angel Ruiz
- Donation and Transplant Coordination Section, Hospital Clínic–Universitat de Barcelona, Barcelona, Spain
| | - Maria Eugenia Valls
- Department of Clinical Microbiology, Centre for Biomedical Diagnosis, Hospital Clínic, Barcelona, Spain
| | - Jordi Vila
- ISGlobal, Barcelona Ctr. Int. Health Res. (CRESIB), Hospital Clínic—Universitat de Barcelona, Barcelona, Spain
- Department of Clinical Microbiology, Centre for Biomedical Diagnosis, Hospital Clínic, Barcelona, Spain
| | - Jose Muñoz
- ISGlobal, Barcelona Ctr. Int. Health Res. (CRESIB), Hospital Clínic—Universitat de Barcelona, Barcelona, Spain
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Ventura-Aguiar P, Ferrer J, Revuelta I, Paredes D, de Sousa-Amorim E, Rovira J, Esmatjes E, Garcia-Valdecasas JC, Campistol JM, Oppenheimer F, Diekmann F, Ricart MJ. Pancreas outcomes between living and deceased kidney donor in pancreas after kidney transplantation patients. Nephrol Dial Transplant 2018; 33:2052-2059. [DOI: 10.1093/ndt/gfy133] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/30/2023] Open
Affiliation(s)
- Pedro Ventura-Aguiar
- Renal Transplant Unit, Nephrology and Kidney Transplantation Department, Hospital Clinic, Barcelona, Spain
- Laboratori Experimental de Nefrologia I Trasplantament (LENIT), CRB CELLEX, Fundació Clínic, IDIBAPS, Barcelona, Spain
| | - Joana Ferrer
- Hepatobiliopancreatic and Liver Transplant Department, Hospital Clinic, Barcelona, Spain
| | - Ignacio Revuelta
- Renal Transplant Unit, Nephrology and Kidney Transplantation Department, Hospital Clinic, Barcelona, Spain
- Laboratori Experimental de Nefrologia I Trasplantament (LENIT), CRB CELLEX, Fundació Clínic, IDIBAPS, Barcelona, Spain
- REDinREN, Madrid, Spain
| | - David Paredes
- Organ Transplantation Coordination Department, Hospital Clinic, Barcelona, Spain
| | - Erika de Sousa-Amorim
- Renal Transplant Unit, Nephrology and Kidney Transplantation Department, Hospital Clinic, Barcelona, Spain
| | - Jordi Rovira
- Laboratori Experimental de Nefrologia I Trasplantament (LENIT), CRB CELLEX, Fundació Clínic, IDIBAPS, Barcelona, Spain
| | - Enric Esmatjes
- Diabetes Unit, Department of Endocrinology and Nutrition, Hospital Clinic, Barcelona, Spain
| | | | - Josep M Campistol
- Renal Transplant Unit, Nephrology and Kidney Transplantation Department, Hospital Clinic, Barcelona, Spain
- Laboratori Experimental de Nefrologia I Trasplantament (LENIT), CRB CELLEX, Fundació Clínic, IDIBAPS, Barcelona, Spain
- REDinREN, Madrid, Spain
| | - Federico Oppenheimer
- Renal Transplant Unit, Nephrology and Kidney Transplantation Department, Hospital Clinic, Barcelona, Spain
| | - Fritz Diekmann
- Renal Transplant Unit, Nephrology and Kidney Transplantation Department, Hospital Clinic, Barcelona, Spain
- Laboratori Experimental de Nefrologia I Trasplantament (LENIT), CRB CELLEX, Fundació Clínic, IDIBAPS, Barcelona, Spain
- REDinREN, Madrid, Spain
| | - Maria José Ricart
- Renal Transplant Unit, Nephrology and Kidney Transplantation Department, Hospital Clinic, Barcelona, Spain
- REDinREN, Madrid, Spain
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Rodríguez-Villar C, Paredes D, Roque R, Gelpi R, Ruíz A, Ventura-Aguiar P, Ferrer J, Diekmann F, Adalia R. Predictive and Comparative Study Between Clinic Consensus Document for Pancreas Acceptance and Predictive Value of Preprocurement Pancreas Allocation Suitability Score (P-PASS). Transplant Proc 2018; 51:365-368. [PMID: 30879542 DOI: 10.1016/j.transproceed.2018.10.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2018] [Accepted: 10/23/2018] [Indexed: 11/17/2022]
Abstract
The strict selection of pancreas for transplant has forced the development of different documents to select the suitable organ in order to minimize the risks and complications of the transplant. In 2008, Eurotransplant published the Preprocurement Pancreas Allocation Suitability Score (P-PASS) for pretransplant selection. In 2001 the Hospital Clinic of Barcelona developed a Clinical Consensus Document (CCD). OBJECTIVES We aimed to analyze the predictive decision of the pancreas acceptance to offers received in the hospital, according to the CCD criteria and compare it with the recommended value of suitability for accepting the pancreas according to the P-PASS value. MATERIAL AND METHODS We performed a retrospective comparative study between the criteria of selection of the CCD for pancreas from 2016-2017 in comparison with the values obtained if the P-PASS had been used: ≤ 17, acceptance criteria and P-PASS; > 17, risk criteria. We defined the organ reported as rejected or accepted. The accepted organ could be procured and transplanted or discarded. RESULTS With the CCD criteria, 7 more organs were transplanted than if we only applied the potential P-PASS criteria. In contrast, P-PASS would have ruled out an additional 9% of pancreases in relation to CCD criteria. CONCLUSIONS According our experience, it is difficult to find an adequate prediction model to select pancreas for transplantation. The application of the DCC criteria increases the number of organs valid for transplantation. At present, new criteria should be re-evaluated within multicenter studies.
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Affiliation(s)
- C Rodríguez-Villar
- Donation and Transplant Coordination Section, Hospital Clinic, Barcelona, Spain.
| | - D Paredes
- Donation and Transplant Coordination Section, Hospital Clinic, Barcelona, Spain
| | - R Roque
- Donation and Transplant Coordination Section, Hospital Clinic, Barcelona, Spain
| | - R Gelpi
- Kidney Transplant Unit, Hospital Clinic, Barcelona, Spain
| | - A Ruíz
- Donation and Transplant Coordination Section, Hospital Clinic, Barcelona, Spain
| | | | - J Ferrer
- Hepatobiliopancreatic and Liver Transplant Department, Hospital Clinic, Barcelona, Spain
| | - F Diekmann
- Kidney Transplant Unit, Hospital Clinic, Barcelona, Spain
| | - R Adalia
- Donation and Transplant Coordination Section, Hospital Clinic, Barcelona, Spain
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Rodríguez E, González M, Paredes D, Campos M, Benítez E. Selecting native perennial plants for ecological intensification in Mediterranean greenhouse horticulture. Bull Entomol Res 2018; 108:694-704. [PMID: 29198200 DOI: 10.1017/s0007485317001237] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Natural control by predators and parasitoids provides an important and often unnoticed ecosystem service to agricultural landscapes by reducing pest populations in crops. The current model of horticultural intensification in south-eastern Spain produces high yields but has also resulted in a landscape almost completely covered by plastic. Promoting natural areas among greenhouses could enhance biodiversity, by being beneficial insects, and reduce pest pressure outdoors. The first step is to ascertain how pests and their natural enemies (NEs) use Mediterranean vegetation for selecting the best plants for pest suppression outdoors. The abundance of the two major horticultural pests, the tobacco whitefly, Bemisia tabaci, and the western flower thrips, Frankliniella occidentalis, together with their NEs, were assayed in 22 flowering perennial plants, which were newly planted in an experimental field surrounded by greenhouses. Eight plant species were identified as the most critical species for sustaining pest populations outdoors. A set of five plant species supported a medium level of pests, and another set of ten plant species supported the lowest level of both pests. Tobacco whitefly occurred in a few plants species, whereas western flower thrips occurred on almost all the plant species studied, and was favoured by the presence of flowers in perennial plants. The results suggest that plant diversity may provide relatively few acceptable host plants for tobacco whitefly than for western flower thrips. NEs were generally collected in plants that also supported abundance of pests, indicating that host/prey availability, more than food resources from flowers, was a stronger predictor of NE abundance in perennial plants. Field trials using the plants with the lowest host acceptance by pests are needed in order to ascertain whether pest abundance outdoors is reduced.
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Affiliation(s)
| | - M González
- Cajamar- Experimental Station 'Las Palmerillas',El Ejido,Almería,Spain
| | - D Paredes
- Department of Environmental Protection,Zaidín-Experimental Station (EEZ),CSIC,Granada,Spain
| | - M Campos
- Department of Environmental Protection,Zaidín-Experimental Station (EEZ),CSIC,Granada,Spain
| | - E Benítez
- Department of Environmental Protection,Zaidín-Experimental Station (EEZ),CSIC,Granada,Spain
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29
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Menjivar A, Torres X, Paredes D, Avinyo N, Peri JM, De Sousa-Amorim E, Oppenheimer F, Manyalich M, Diekmann F, Revuelta I. Assessment of donor satisfaction as an essential part of living donor kidney transplantation: an eleven-year retrospective study. Transpl Int 2018; 31:1332-1344. [DOI: 10.1111/tri.13334] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2018] [Revised: 03/30/2018] [Accepted: 08/21/2018] [Indexed: 12/27/2022]
Affiliation(s)
- Ana Menjivar
- Medical School; University of Barcelona; Barcelona Spain
- Laboratori Experimental de Nefrologia i Trasplantament (LENIT); Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS); Barcelona Spain
| | - Xavier Torres
- Psychiatry and Clinical Psychology Service; Institut Clinic de Neurociencies; Hospital Clinic of Barcelona; Barcelona Spain
| | - David Paredes
- Medical School; University of Barcelona; Barcelona Spain
- Donation and Transplant Coordination Section; Hospital Clinic of Barcelona; Barcelona Spain
| | - Nuria Avinyo
- Fundació Clínic per a la Recerca Biomèdica; Barcelona Spain
| | - Josep Maria Peri
- Psychiatry and Clinical Psychology Service; Institut Clinic de Neurociencies; Hospital Clinic of Barcelona; Barcelona Spain
| | - Erika De Sousa-Amorim
- Department of Nephrology and Renal Transplantation; Hospital Clinic of Barcelona; Barcelona Spain
| | - Federico Oppenheimer
- Laboratori Experimental de Nefrologia i Trasplantament (LENIT); Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS); Barcelona Spain
- Department of Nephrology and Renal Transplantation; Hospital Clinic of Barcelona; Barcelona Spain
| | - Marti Manyalich
- Medical School; University of Barcelona; Barcelona Spain
- Transplant Assessorial Unit; Medical Direction; Hospital Clinic of Barcelona; Barcelona Spain
| | - Fritz Diekmann
- Laboratori Experimental de Nefrologia i Trasplantament (LENIT); Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS); Barcelona Spain
- Department of Nephrology and Renal Transplantation; Hospital Clinic of Barcelona; Barcelona Spain
| | - Ignacio Revuelta
- Medical School; University of Barcelona; Barcelona Spain
- Laboratori Experimental de Nefrologia i Trasplantament (LENIT); Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS); Barcelona Spain
- Department of Nephrology and Renal Transplantation; Hospital Clinic of Barcelona; Barcelona Spain
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30
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Roque R, Rodríguez-Villar C, Ruíz A, Paredes D, Gelpi R, Rodríguez S, García FJ, Adalia R. Relatives' Perception After Tissue Donation Experience: Results of a Postdonation Phone Survey. Transplant Proc 2018; 49:2296-2298. [PMID: 29198664 DOI: 10.1016/j.transproceed.2017.10.018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
INTRODUCTION Postmortem tissue donation (TD) requires the establishment of strategies for family approach to clearly explain the characteristics of multi-tissue donation. In a tertiary university hospital with a long tradition of tissue generation, we designed a survey to be applied to tissue donor families to evaluate global hospital care, care from Transplant Coordinators (TC), quality and content of information given about TD, experience, and motivations after TD process. METHODOLOGY A prospective phone survey of 10 multiple-choice items was conducted to all TD relatives that agreed to donate one or more tissues. RESULTS From the 166 calls made to TD relatives, 75 (45%) were answered: 50 were cornea donors and 25 were multiple-tissues donors. None of the relatives denied participating, the rest were not found. No statistical differences in demographical variables were found between both types of TD. The hospital and TC care perception, the quality of the given information about the processes of TD, the postdonation experiences in terms of procedures, and the impression about body appearance for relatives regardless of the type of donation, corneas or multiple tissues, were evaluated as good or very good for most of the TD relatives. Our study showed that 83% of the family members would agree to donate again; 40% of the relatives were surprised to be offered the option to donate; 10% did not know if they would donate again. Solidarity was the leading reason for TD. CONCLUSION The relatives' perception of care is a critical component of the quality evaluation of the TD process. The global evaluation results support our strategies for family approach.
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Affiliation(s)
- R Roque
- Donation and Transplant Coordination Unit, Hospital Clínic Barcelona, Barcelona, Spain.
| | - C Rodríguez-Villar
- Donation and Transplant Coordination Unit, Hospital Clínic Barcelona, Barcelona, Spain
| | - A Ruíz
- Donation and Transplant Coordination Unit, Hospital Clínic Barcelona, Barcelona, Spain
| | - D Paredes
- Donation and Transplant Coordination Unit, Hospital Clínic Barcelona, Barcelona, Spain
| | - R Gelpi
- Donation and Transplant Coordination Unit, Hospital Clínic Barcelona, Barcelona, Spain
| | - S Rodríguez
- Donation and Transplant Coordination Unit, Hospital Clínic Barcelona, Barcelona, Spain
| | - F J García
- Donation and Transplant Coordination Unit, Hospital Clínic Barcelona, Barcelona, Spain
| | - R Adalia
- Donation and Transplant Coordination Unit, Hospital Clínic Barcelona, Barcelona, Spain
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Gelpi R, Rodríguez-Villar C, Paredes D, Roque R, Ruiz A, Adalia R, de Sousa E, Revuelta I, Sole M, Martinez M, Navarro M, Lens S, Oppenheimer F, Diekmann F. Safety of hepatitis C virus (HCV)-treated donors for kidney transplantation excluding occult HCV infection through kidney biopsies. Transpl Int 2018; 31:938-939. [DOI: 10.1111/tri.13270] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Affiliation(s)
- Rosana Gelpi
- Renal Transplant Unit; Hospital Clinic de Barcelona; University of Barcelona; Barcelona Spain
- Donation and Transplant Coordination Section; Hospital Clinic de Barcelona; University of Barcelona; Barcelona Spain
| | - Camino Rodríguez-Villar
- Donation and Transplant Coordination Section; Hospital Clinic de Barcelona; University of Barcelona; Barcelona Spain
| | - David Paredes
- Donation and Transplant Coordination Section; Hospital Clinic de Barcelona; University of Barcelona; Barcelona Spain
| | - Rebeca Roque
- Donation and Transplant Coordination Section; Hospital Clinic de Barcelona; University of Barcelona; Barcelona Spain
| | - Angel Ruiz
- Donation and Transplant Coordination Section; Hospital Clinic de Barcelona; University of Barcelona; Barcelona Spain
| | - Ramon Adalia
- Donation and Transplant Coordination Section; Hospital Clinic de Barcelona; University of Barcelona; Barcelona Spain
| | - Erika de Sousa
- Renal Transplant Unit; Hospital Clinic de Barcelona; University of Barcelona; Barcelona Spain
| | - Ignacio Revuelta
- Renal Transplant Unit; Hospital Clinic de Barcelona; University of Barcelona; Barcelona Spain
| | - Manuel Sole
- Pathology Department; Hospital Clinic de Barcelona; University of Barcelona; Barcelona Spain
| | - Miguel Martinez
- Department of Clinical Microbiology; Barcelona Centre for International Health Research (CRESIB); Barcelona Spain
| | - Mireia Navarro
- Department of Clinical Microbiology; Barcelona Centre for International Health Research (CRESIB); Barcelona Spain
| | - Sabela Lens
- Liver Unit; IDIBAPS; CIBEREHD; University of Barcelona; Barcelona Spain
| | - Federico Oppenheimer
- Renal Transplant Unit; Hospital Clinic de Barcelona; University of Barcelona; Barcelona Spain
| | - Fritz Diekmann
- Renal Transplant Unit; Hospital Clinic de Barcelona; University of Barcelona; Barcelona Spain
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Cucchiari D, Rovira J, Paredes D, Ventura-Aguiar P, Sanchez-Escuredo A, Solé M, Adalia R, Oppenheimer F, Diekmann F, Revuelta I. Association of Brain-Dead Donors' Terminal Inflammation With Delayed Graft Function in Kidney Transplant Recipients. Transplant Proc 2017; 49:2260-2264. [PMID: 29198657 DOI: 10.1016/j.transproceed.2017.10.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND Systemic inflammation affects kidney function in a wide range of diseases. Even in kidney transplant recipients, higher levels of C-reactive protein (CRP) are invariably associated with both worse short- and long-term graft outcomes. However, little is known about systemic inflammation in kidney donors and, notably, brain death causes a strong systemic inflammatory response. OBJECTIVE To analyze the role of systemic inflammation of brain-dead donors on short-term kidney graft outcomes (ie, delayed graft function [DGF], defined as the need of dialysis during the first week after transplantation). MATERIALS AND METHODS Retrospective analysis of clinical and biochemical characteristics of all brain-dead kidney donors generated in the Hospital Clínic of Barcelona in the 2006 to 2015 period (n = 194). Donors who were tested for CRP in the 24 hours before BD declaration were included (n = 97, 50% of initial population). Clinical and biochemical features of their respective recipients (n = 165) were analyzed, comparing recipients who developed DGF (n = 30) with recipients who did not (n = 135). RESULTS Donors whose recipients later developed DGF had much higher CRP values (10.58 [5.1-18.21] vs 4.81 [1.42-12.2] mg/dL, P = .025). Other characteristics associated with the development of DGF were renal biopsy score and recipient dialysis vintage (P = .025 and P = .002, respectively). In logistic regression analysis, PCR maintained significance in the non-expanded criteria donor (ECD) group (odds ratio [OR], 1.102; P = .027), but it lost significance in the ECD group (P = .67). CONCLUSIONS Terminal donor CRP was associated with DGF in kidney transplant recipients and proved to be mostly significant in younger donors.
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Affiliation(s)
- D Cucchiari
- Department of Nephrology and Urology, Renal Transplant Unit, Hospital Clínic, Barcelona, Spain; Nephrology and Dialysis Unit, Humanitas Clinical and Research Center, Rozzano, Milan, Italy
| | - J Rovira
- Laboratori Experimental de Nefrologia I Trasplantament (LENIT), CRB CELLEX, Fundació Clínic, IDIBAPS, Barcelona, Spain
| | - D Paredes
- Transplant Coordination Unit, Hospital Clínic, Barcelona, Spain
| | - P Ventura-Aguiar
- Department of Nephrology and Urology, Renal Transplant Unit, Hospital Clínic, Barcelona, Spain; Laboratori Experimental de Nefrologia I Trasplantament (LENIT), CRB CELLEX, Fundació Clínic, IDIBAPS, Barcelona, Spain
| | - A Sanchez-Escuredo
- Department of Nephrology and Urology, Renal Transplant Unit, Hospital Clínic, Barcelona, Spain
| | - M Solé
- Pathology Department, Hospital Clínic, Barcelona, Spain
| | - R Adalia
- Transplant Coordination Unit, Hospital Clínic, Barcelona, Spain
| | - F Oppenheimer
- Department of Nephrology and Urology, Renal Transplant Unit, Hospital Clínic, Barcelona, Spain; Laboratori Experimental de Nefrologia I Trasplantament (LENIT), CRB CELLEX, Fundació Clínic, IDIBAPS, Barcelona, Spain
| | - F Diekmann
- Department of Nephrology and Urology, Renal Transplant Unit, Hospital Clínic, Barcelona, Spain; Laboratori Experimental de Nefrologia I Trasplantament (LENIT), CRB CELLEX, Fundació Clínic, IDIBAPS, Barcelona, Spain
| | - I Revuelta
- Department of Nephrology and Urology, Renal Transplant Unit, Hospital Clínic, Barcelona, Spain; Laboratori Experimental de Nefrologia I Trasplantament (LENIT), CRB CELLEX, Fundació Clínic, IDIBAPS, Barcelona, Spain.
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Sánchez-Escuredo A, Sagasta A, Revuelta I, Rodas LM, Paredes D, Musquera M, Diekmann F, Campistol JM, Solé M, Oppenheimer F. Histopathological evaluation of pretransplant donor biopsies in expanded criteria donors with high kidney donor profile index: a retrospective observational cohort study. Transpl Int 2017; 30:975-986. [PMID: 28403541 DOI: 10.1111/tri.12966] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2016] [Revised: 01/24/2017] [Accepted: 03/27/2017] [Indexed: 12/16/2022]
Abstract
There is no consensus on the allocation of renal transplants from expanded criteria donors (ECD). The Kidney Donor Profile Index (KDPI) is used without the need for pretransplant donor biopsies (PTDB). We explored whether PTDB based on Remuzzi Score (RS) allows identification of those marginal kidneys in the highest calculated KDPI risk group (>91%) that appropriate for single transplantation. A retrospective study was conducted of 485 consecutive kidneys procured from a single center and transplanted if the RS was ≤4. We compared 5-year kidney and patients survival between KDPI groups and between RS <4 or =4 in the highest KDPI group. The median KDPI (interquartile range) was 71 (66-76) for KDPI <80% (n = 77), 86 (81-90) for KDPI 81-90% (n = 82), and 97 (94-100) for KDPI >91% (n = 205). Patient survival at 5 years was 85.7%, 85.3%, and 76.09% (P = 0.058) and death-censored graft survival was 84.4%, 86.5%, 73.6% (P = 0.015), respectively for each KDPI group. In >91% calculated KDPI group, there were no differences in graft survival depending on the RS (<4 vs. =4) (P = 0.714). The implementation of PTDB based on RS used for allocation of organs with the highest KDPI range could support to the acceptance of suitable organs for single transplantation with good patient and graft survival rate.
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Affiliation(s)
- Ana Sánchez-Escuredo
- Nephrology and Renal Transplant Department, Hospital Clinic, Universitat de Barcelona, Barcelona, Spain
| | - Amaia Sagasta
- Pathology Department, Hospital Clinic, Universitat de Barcelona, Barcelona, Spain
| | - Ignacio Revuelta
- Nephrology and Renal Transplant Department, Hospital Clinic, Universitat de Barcelona, Barcelona, Spain
| | - Lida M Rodas
- Nephrology and Renal Transplant Department, Hospital Clinic, Universitat de Barcelona, Barcelona, Spain
| | - David Paredes
- Transplant Service Foundation, Hospital Clinic, Universitat de Barcelona, Barcelona, Spain
| | - Mireia Musquera
- Urology Department, Hospital Clinic, Universitat de Barcelona, Barcelona, Spain
| | - Fritz Diekmann
- Nephrology and Renal Transplant Department, Hospital Clinic, Universitat de Barcelona, Barcelona, Spain
| | - Josep M Campistol
- Nephrology and Renal Transplant Department, Hospital Clinic, Universitat de Barcelona, Barcelona, Spain
| | - Manel Solé
- Pathology Department, Hospital Clinic, Universitat de Barcelona, Barcelona, Spain
| | - Federico Oppenheimer
- Nephrology and Renal Transplant Department, Hospital Clinic, Universitat de Barcelona, Barcelona, Spain
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Araya BM, Díaz M, Paredes D, Ortiz J. Association between preterm birth and its subtypes and maternal sociodemographic characteristics during the post-transitional phase in a developing country with a very high human development index. Public Health 2017; 147:39-46. [PMID: 28404494 DOI: 10.1016/j.puhe.2017.01.027] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2016] [Revised: 11/28/2016] [Accepted: 01/27/2017] [Indexed: 11/26/2022]
Abstract
OBJECTIVES Chile is a post-transitional country evolving towards a stationary population pyramid, which may be associated with increasing preterm birth (PTB) rates. This study aimed to compare maternal sociodemographic characteristics between the start of the post-transition phase (1994) and an established stage (2013) and to evaluate associations between these characteristics and PTB. STUDY DESIGN An observational analytic design was conducted using national birth records (n = 4,956,311). METHODS Variables analysed in the 20 birth cohorts from 1994 to 2013 were: length of gestation (preterm <37 weeks) subdivided by gestational age (extreme, moderate/severe and late); maternal age (≤19, 20-35 and >35 years); education level (<8, 8-12 and >12 years of education); employment; marital status; area of residence; and type of birth (singleton, twins, and triplets or higher order). The prevalence of PTB was expressed as a percentage, and associations between PTB and predictor variables were analysed using logistic regression models. RESULTS Education level, age >35 years, maternal employment, unmarried status, twin delivery and urban residency rates increased between 1994 and 2013. According to the adjusted models, age >35 years and delivery of more than two foetuses were risk factors for all PTB subtypes. Maternal employment was a risk factor for moderate/severe, late and total PTB, and a low level of education was a risk factor for late and total PTB. On the other hand, age ≤19 years was protective against all PTB subtypes. CONCLUSIONS All maternal characteristics changed between 1994 and 2013. Furthermore, the prevalence of PTB increased for all predictor variables studied over this period.
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Affiliation(s)
- B M Araya
- Department of Women and Newborn Health Promotion, Faculty of Medicine, University of Chile, Santiago, Chile.
| | - M Díaz
- Department of Women and Newborn Health Promotion, Faculty of Medicine, University of Chile, Santiago, Chile
| | - D Paredes
- Department of Women and Newborn Health Promotion, Faculty of Medicine, University of Chile, Santiago, Chile
| | - J Ortiz
- Department of Women and Newborn Health Promotion, Faculty of Medicine, University of Chile, Santiago, Chile
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Roque R, Rodriguez-Villar C, Ruiz A, Paredes D, Gelpi R, Garcia X, Vizcaíno F, Saavedra S, Rodríguez S, Quijada M, Bohils M, Adalia R. Quality Assessment of Postmortem Tissue Donors in a University Hospital: Detection and Generation Tissue Indicators. Transplant Proc 2016; 48:2859-2861. [DOI: 10.1016/j.transproceed.2016.08.040] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2016] [Accepted: 08/04/2016] [Indexed: 12/21/2022]
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36
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Sánchez-Escuredo A, Oppenheimer F, Solé M, Revuelta I, Cid J, Lozano M, Blasco M, Esforzado N, Ricart MJ, Cofán F, Torregrosa JV, Paredes D, Musquera M, Ercilla G, Campistol JM, Diekmann F. Borderline rejection in ABO-incompatible kidney transplantation. Clin Transplant 2016; 30:872-9. [DOI: 10.1111/ctr.12759] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/29/2016] [Indexed: 12/26/2022]
Affiliation(s)
- Anna Sánchez-Escuredo
- Nephrology and Renal Transplant Department; Hospital Clinic; Universitat de Barcelona; Barcelona Spain
| | - Federico Oppenheimer
- Nephrology and Renal Transplant Department; Hospital Clinic; Universitat de Barcelona; Barcelona Spain
| | - Manel Solé
- Pathology Department; Hospital Clinic; Universitat de Barcelona; Barcelona Spain
| | - Ignacio Revuelta
- Nephrology and Renal Transplant Department; Hospital Clinic; Universitat de Barcelona; Barcelona Spain
| | - Joan Cid
- Apheresis Unit; Hemotherapy and Hemostasis Department; CDB; IDIBAPS Hospital Clinic; University of Barcelona; Barcelona Spain
| | - Miguell Lozano
- Apheresis Unit; Hemotherapy and Hemostasis Department; CDB; IDIBAPS Hospital Clinic; University of Barcelona; Barcelona Spain
| | - Miquel Blasco
- Nephrology and Renal Transplant Department; Hospital Clinic; Universitat de Barcelona; Barcelona Spain
| | - Nuria Esforzado
- Nephrology and Renal Transplant Department; Hospital Clinic; Universitat de Barcelona; Barcelona Spain
| | - Maria Jose Ricart
- Nephrology and Renal Transplant Department; Hospital Clinic; Universitat de Barcelona; Barcelona Spain
| | - Federico Cofán
- Nephrology and Renal Transplant Department; Hospital Clinic; Universitat de Barcelona; Barcelona Spain
| | - Josep Vicens Torregrosa
- Nephrology and Renal Transplant Department; Hospital Clinic; Universitat de Barcelona; Barcelona Spain
| | - David Paredes
- Transplant Service Foundation; Hospital Clinic; Universitat de Barcelona; Barcelona Spain
| | - Mireia Musquera
- Urology Department; Hospital Clinic; Universitat de Barcelona; Barcelona Spain
| | - Guadalupe Ercilla
- Immunology Department; Hospital Clinic; Universitat de Barcelona; Barcelona Spain
| | - Josep M. Campistol
- Nephrology and Renal Transplant Department; Hospital Clinic; Universitat de Barcelona; Barcelona Spain
| | - Fritz Diekmann
- Nephrology and Renal Transplant Department; Hospital Clinic; Universitat de Barcelona; Barcelona Spain
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Sagasta A, Sánchez-Escuredo A, Oppenheimer F, Paredes D, Musquera M, Campistol JM, Solé M. Pre-implantation analysis of kidney biopsies from expanded criteria donors: testing the accuracy of frozen section technique and the adequacy of their assessment by on-call pathologists. Transpl Int 2015; 29:234-40. [DOI: 10.1111/tri.12709] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2015] [Revised: 08/20/2015] [Accepted: 10/23/2015] [Indexed: 11/29/2022]
Affiliation(s)
- Amaia Sagasta
- Pathology Department; Hospital Clinic; Universitat de Barcelona; Barcelona Spain
| | - Ana Sánchez-Escuredo
- Nephrology and Renal Transplant Department; Hospital Clinic; Universitat de Barcelona; Barcelona Spain
| | - Frederic Oppenheimer
- Nephrology and Renal Transplant Department; Hospital Clinic; Universitat de Barcelona; Barcelona Spain
| | - David Paredes
- Transplant Service Fundation; Hospital Clinic; Universitat de Barcelona; Barcelona Spain
| | - Mireia Musquera
- Urology Department; Hospital Clinic; Universitat de Barcelona; Barcelona Spain
| | - Josep Maria Campistol
- Nephrology and Renal Transplant Department; Hospital Clinic; Universitat de Barcelona; Barcelona Spain
| | - Manel Solé
- Pathology Department; Hospital Clinic; Universitat de Barcelona; Barcelona Spain
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38
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Rodríguez-Villar C, Conget I, Ferrer-Fàbrega J, Paredes D, Ruíz A, Roque R, Rull R, López-Boado M, Ricart MJ, Garcia R, Adalia R. Successful Pancreas Transplantation From a Deceased Donor Intoxicated With Oral Antidiabetic Agent: A Case Report. Transplant Proc 2015; 47:2404-6. [PMID: 26518941 DOI: 10.1016/j.transproceed.2015.08.028] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Simultaneous kidney pancreas transplantation (SKP) is a common procedure for the patient with long-term type 1 diabetes mellitus (DM) with terminal renal failure. It is unusual to consider the pancreas from a deceased donor who died after an acute intoxication with oral antidiabetic agent (OAA), which would suggest an abnormal functionality of the organ and preclude the potential use of the graft. We present a case of a successful pancreatic transplantation from a donor who died of acute cerebral edema secondary to severe hypoglycemia induced by OAA acute intoxication.
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Affiliation(s)
| | - I Conget
- Unidad de Diabetes, Servicio de Endocrinología y Nutición, Barcelona, Spain
| | - J Ferrer-Fàbrega
- Cirugía Hepato-Bilio-Pancreática y Trasplante de Hígado y Páncreas, Barcelona, Spain
| | - D Paredes
- Sección de Donación y Coordinación de Trasplantes, Barcelona, Spain
| | - A Ruíz
- Sección de Donación y Coordinación de Trasplantes, Barcelona, Spain
| | - R Roque
- Sección de Donación y Coordinación de Trasplantes, Barcelona, Spain
| | - R Rull
- Cirugía Hepato-Bilio-Pancreática y Trasplante de Hígado y Páncreas, Barcelona, Spain
| | - M López-Boado
- Cirugía Hepato-Bilio-Pancreática y Trasplante de Hígado y Páncreas, Barcelona, Spain
| | - M J Ricart
- Unidad de Trasplante Renal, Barcelona, Spain
| | - R Garcia
- Cirugía Hepato-Bilio-Pancreática y Trasplante de Hígado y Páncreas, Barcelona, Spain
| | - R Adalia
- Sección de Donación y Coordinación de Trasplantes, Barcelona, Spain
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39
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Vendrell M, Hessheimer AJ, Ruiz A, de Sousa E, Paredes D, Rodríguez C, Saavedra S, Fuster J, Alcaraz A, Oppenheimer F, Taurá P, García-Valdecasas JC, Fondevila C. Coagulation profiles of unexpected DCDD donors do not indicate a role for exogenous fibrinolysis. Am J Transplant 2015; 15:764-71. [PMID: 25655040 DOI: 10.1111/ajt.13058] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2014] [Revised: 10/08/2014] [Accepted: 10/11/2014] [Indexed: 01/25/2023]
Abstract
It has been suggested that vascular stasis during cardio-circulatory arrest leads to the formation of microvascular thrombi and the viability of organs arising from donation after circulatory determination of death (DCDD) donors may be improved through the application of fibrinolytic therapy. Our aim was to comprehensively study the coagulation profiles of Maastricht category II DCDD donors in order to determine the presence of coagulation abnormalities that could benefit from fibrinolytic therapy. Whole blood from potential DCDD donors suffering out-of-hospital cardiac arrest was sampled after declaration of death in the emergency department, and rotational thromboelastomeric analysis was performed. Between July 2012 and December 2013, samples from 33 potential DCDD donors were analyzed. All patients demonstrated hyperfibrinolysis (HF), as reflected by maximum clot lysis of 98-100% in all cases, indicating that there is no role for additional fibrinolytic therapy in this setting. As well, we observed correlations between thromboelastomeric lysis parameters and maximum hepatic transaminase levels measured in potential donors and renal artery flows measured during ex situ hypothermic oxygenated machine perfusion, indicating that further studies on the utility of thromboelastometry to evaluate organ injury and perhaps even viability in unexpected DCDD may be warranted.
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Affiliation(s)
- M Vendrell
- Anesthesiology, Hospital Clínic, University of Barcelona, Barcelona, Spain
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40
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Galvis V, Tello A, Jaramillo LC, Paredes D, Camacho PA. Prevalence of Punctate Keratopathy of West Indians in a Colombian Referral Center and a New Name Proposed: Rice´s Keratopathy. Open Ophthalmol J 2015; 9:12-6. [PMID: 25713637 PMCID: PMC4333615 DOI: 10.2174/1874364101509010012] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2014] [Revised: 01/20/2015] [Accepted: 01/22/2015] [Indexed: 12/02/2022] Open
Abstract
Purpose : To perform a prevalence study of Punctate Keratopathy of West Indians in Colombian individuals and to propose a new name for the condition. Methods : Prospective, population-based epidemiological study. All patients evaluated between November 1 and December 31, 2012, in the Centro Oftalmológico Virgilio Galvis and Fundación Oftalmológica de Santander (FOSCAL), Floridablanca, Colombia, with clinical findings of white corneal opacities corresponding to Punctate Keratopathy of West Indians were identified. Careful slit-lamp examination was performed for clinical diagnosis and findings were reported in the electronic medical record indicating number and location of the lesions. Prevalence was calculated for the total population, and for gender and age groups. Furthermore a literature review was performed and a new name for the condition proposed. Results : In the whole group of patients, prevalence was 1.0%. No one case was diagnosed in a patient younger than 21 year-old. No one lesion was located within 2.5 mm of the corneal apex. 96% of affected patients had unilateral involvement. 58.5% of eyes had a single corneal lesion; 7% of eyes had 6 or 7 corneal lesions. Conclusion : The condition heretofore known as Punctate Keratopathy of West Indians was present in 1% of our patients in Colombia (South America). Thus, this non-infectious, non-inflammatory, asymptomatic ailment of unknown etiology is not restricted to people of Antillean descent, or who have lived in these islands. We propose the new name “Rice's keratopathy". Age and male gender were independent risk factors for the presence of the keratopathy.
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Affiliation(s)
- Virgilio Galvis
- Department of Ophthalmology, Centro Oftalmológico Virgilio Galvis, Floridablanca, Santander, Colombia ; Universidad Autónoma de Bucaramanga, Bucaramanga, Santander, Colombia
| | - Alejandro Tello
- Department of Ophthalmology, Centro Oftalmológico Virgilio Galvis, Floridablanca, Santander, Colombia ; Universidad Autónoma de Bucaramanga, Bucaramanga, Santander, Colombia
| | - Luis C Jaramillo
- Universidad Autónoma de Bucaramanga, Bucaramanga, Santander, Colombia ; Fundación Oftalmológica de Santander (FOSCAL), Floridablanca, Santander, Colombia
| | - David Paredes
- Universidad Autónoma de Bucaramanga, Bucaramanga, Santander, Colombia ; Fundación Oftalmológica de Santander (FOSCAL), Floridablanca, Santander, Colombia
| | - Paul A Camacho
- Fundación Oftalmológica de Santander (FOSCAL), Floridablanca, Santander, Colombia ; Department of Investigation, Development and Technological Innovation, Fundación Oftalmológica de Santander (FOSCAL), Floridablanca, Santander, Colombia
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41
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Lledó-García E, Riera L, Passas J, Paredes D, Morales JM, Sánchez-Escuredo A, Burgos-Revilla FJ, de Andrés Belmonte A, Oppenheimer F, Rodríguez-Ferrero ML, Solé M, Matesanz R, Valentín M, Pascual J. Spanish consensus document for acceptance and rejection of kidneys from expanded criteria donors. Clin Transplant 2014; 28:1155-66. [PMID: 25109314 DOI: 10.1111/ctr.12434] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/05/2014] [Indexed: 01/20/2023]
Abstract
In the recent years, more than 60% of available deceased donors are either older than 50 yr or have significant vascular comorbidities. This makes the acceptance and rejection criteria of renal allografts very rigorous, especially in cases of younger recipients, and at the same time encourages live donations. In our country, there is a lack of homogeneity in the percentages of use of expanded criteria donor (ECD) allografts between the different autonomous communities. Furthermore, the criteria vary greatly, and in some cases, great importance is given to the biopsy while in others very little. In this study, we present a unified and homogenous criteria agreed upon by consensus of a 10-member Panel representing major scientific societies related to renal transplantation in Spain. The criteria are to be used in accepting and/or rejecting kidneys from the so-called ECDs. The goal was to standardize the use of these organs, to optimize the results, and most importantly to provide for the maximum well being of our patients. Finally, we believe that after taking into account the Panel's thorough review of specific scientific literature, this document will be adaptable to other national renal transplant programmes.
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Teixeira J, Maio R, Immer F, Dominguez J, Papalois V, Mihály S, Paredes D. The Certification of Transplant Coordinators in Europe. Transplant Proc 2014; 46:1265-73. [DOI: 10.1016/j.transproceed.2013.12.063] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2013] [Accepted: 12/19/2013] [Indexed: 11/25/2022]
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Makowski K, Mera P, Paredes D, Herrero L, Ariza X, Asins G, Hegardt FG, García J, Serra D. Differential pharmacologic properties of the two C75 enantiomers: (+)-C75 is a strong anorectic drug; (-)-C75 has antitumor activity. Chirality 2013; 25:281-7. [PMID: 23620264 DOI: 10.1002/chir.22139] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2012] [Accepted: 11/12/2012] [Indexed: 11/12/2022]
Abstract
C75 is a synthetic compound described as having antitumoral properties. It produces hypophagia and weight loss in rodents, limiting its use in cancer therapy but identifying it as a potential anti-obesity drug. C75 is a fatty acid synthase (FAS) inhibitor and, through its coenzyme A (CoA) derivative, it acts as a carnitine palmitoyltransferase (CPT) 1 inhibitor. Racemic mixtures of C75 have been used in all the previous studies; however, the potential different biological activities of C75 enantiomers have not been examined yet. To address this question we synthesized the two C75 enantiomers separately. Our results showed that (-)-C75 inhibits FAS activity in vitro and has a cytotoxic effect on tumor cell lines, without affecting food consumption. (+)-C75 inhibits CPT1 and its administration produces anorexia, suggesting that central inhibition of CPT1 is essential for the anorectic effect of C75. The differential activity of C75 enantiomers may lead to the development of potential new specific drugs for cancer and obesity.
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Affiliation(s)
- Kamil Makowski
- Department of Biochemistry and Molecular Biology, Facultat de Farmàcia, Universitat de Barcelona, E-08028 Barcelona, Spain
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Palma P, Ruiz A, Carmona F, Soliba R, Barrau E, Paredes D. How LUCAS® device affects kidney transplant rate in a “donors after circulatory death” program. Resuscitation 2013. [DOI: 10.1016/j.resuscitation.2013.08.186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Affiliation(s)
- Virgilio Galvis
- Department of Ophthalmology, Centro Oftalmológico Virgilio Galvis, Floridablanca, Santander, Colombia
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46
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Galvis V, Tello A, Revelo ML, Paredes D, Jaramillo LC. Punctate keratopathy of West Indians in patients undergoing photorefractive surgery. BMJ Case Rep 2013; 2013:bcr-2012-008192. [PMID: 23355587 DOI: 10.1136/bcr-2012-008192] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
We present two cases of patients with corneal lesions compatible with punctate keratopathy of West Indians who underwent photorefractive keratectomy and laser-assisted in situ keratomileusis. Both had good postoperative results. The corneal lesions did not interfere with the refractive surgery.
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Affiliation(s)
- Virgilio Galvis
- Department of Ophthalmology, Centro Oftalmológico Virgilio Galvis, Floridablanca, Santander, Colombia
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47
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Rodríguez-Villar C, Paredes D, Alberola M, Ruiz A, Roque R, Saavedra S, Vizcaino F, Portillo M, Bohils M, Adalia R. Perception of Transplant Coordinator Regarding Relatives' Attitude Toward Tissue Donation Request. Transplant Proc 2012; 44:2525-8. [DOI: 10.1016/j.transproceed.2012.09.071] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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48
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Manyalich M, Menjívar A, Yucetin L, Peri J, Torres X, Dias L, Hiesse C, Papachristou C, Fehrman-Ekholm I, Kvarnström N, Ballesté C, Paredes D, Revuelta I, Diekmann F, Rimola A, Fondevila C, Martínez M, Legendre C, Pereira R, Carvalho I, Lopes A. Living Donor Psychosocial Assesment/Follow-up Practices in the Partners' Countries of the ELIPSY Project. Transplant Proc 2012; 44:2246-9. [DOI: 10.1016/j.transproceed.2012.07.106] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
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Fondevila C, Hessheimer AJ, Flores E, Ruiz A, Mestres N, Calatayud D, Paredes D, Rodríguez C, Fuster J, Navasa M, Rimola A, Taurá P, García-Valdecasas JC. Applicability and results of Maastricht type 2 donation after cardiac death liver transplantation. Am J Transplant 2012; 12:162-70. [PMID: 22070538 DOI: 10.1111/j.1600-6143.2011.03834.x] [Citation(s) in RCA: 142] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Maastricht type 2 donation after cardiac death (DCD) donors suffer sudden and unexpected cardiac arrest, typically outside the hospital; they have significant potential to expand the donor pool. Herein, we analyze the results of transplanted livers and all potential donors treated under our type 2 DCD protocol. Cardiac arrest was witnessed; potential donors arrived at the hospital after attempts at resuscitation had failed. Death was declared based on the absence of cardiorespiratory activity during a 5-min no-touch period. Femoral vessels were cannulated to establish normothermic extracorporeal membrane oxygenation, which was maintained until organ recovery. From April 2002 to December 2010, there were 400 potential donors; 34 liver transplants were performed (9%). Among recipients, median age, model for end-stage liver disease and cold and reperfusion warm ischemic times were 55 years (49-60), 19 (14-21) and 380 (325-430) and 30 min (26-35), respectively. Overall, 236 (59%) and 130 (32%) livers were turned down due to absolute and relative contraindications to donate, respectively. One-year recipient and graft survivals were 82% and 70%, respectively (median follow-up 24 months). The applicability of type 2 DCD liver transplant was <10%; however, with better preservation technology and expanded transplant criteria, we may be able to improve this figure significantly.
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Affiliation(s)
- C Fondevila
- Department of Surgery, Liver Transplant Unit, Hospital Clínic, CIBERehd, University of Barcelona, Barcelona, Spain.
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50
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