bluuebunny/crossref_metadata_2025_split huggingface dataset:
P1683INFLUENCE OF BIOPSY PROGNOSIS ON GRAFT SURVIVAL
Authors: Andrades Gómez Cristina , Pérez valdivia Miguel Ángel , Calvillo Arbizu Jorge , Cabrera López Rocío , Suñer Poblet Marta , González Corvillo Carmen 
Published: June 2020

Abstract

Background and Aims
Renal transplantation is the best alternative renal replacement option for patients with advanced chronic kidney disease. However, the supply of young donors is limited, and does not cover the demand of patients on the renal transplant waiting list, for this reason are being used older donors and exists a high discard rate of those organs base on pathological results (score) of the preimplant renal biopsy.
There are several methods to evaluate the quality of the kidneys and the Kidney Donor Profile Index (KDPI) has acquired special relevance to decide the perform of preimplant renal biopsy. Based on the score, a preimplant renal biopsy is performed, which is decisive in certain cases.
However, there is poor evidence to support this decision, which can be described as “conservative,” since there is not enough certainty that there is influence of the preimplant biopsy score score on graft survival.

Method
389 biopsies of kidney transplant donors of cadaver donors in brain death and asystole type III were included. Donors in asystole type II, combined and live, were excluded. Samples examined by the same pathologist and in paraffin (no case by freezing). A graft survival analysis was performed based on the results of the renal biopsy (score). Likewise, a multivariate analysis of graft survival was carried out including, in addition to the results of the renal biopsy, results such as the age of the donor and recipient and the KDPI.

Results
graft survival was compared between two transplant subpopulations in our hospital based on whether a preimplant biopsy was performed. According to the data used there are no significant differences in graft survival between transplants in which biopsy has been performed and those that have not.

Conclusion
our work shows, as is currently the case in the literature, the absence of influence on the score of the preimplant biopsy score on graft survival.
P1690EXPERIENCE WITH EXPANDED CRITERIA DONORS: 10-YEAR SINGLE CENTER ANALYSIS
Authors: Graňák Karol , Matej Vnuäã¡k , Skálová Petra , Miklušica Juraj , Laca Ľudovít , Dedinska Ivana 
Published: June 2020

Abstract

Background and Aims
Kidneys from expanded criteria donors with diagnosis of brain death have become a part of the organ transplant program, which have thus increased the number of transplants.

Method
In this retrospective analysis, we identified the expanded criteria donors in a group of 156 kidney donors at our center. Basic parameters of the donors before kidney recovery were collected. Graft function, graft survival, and patient survival at 1, 3, and 5 years posttransplant were compared in expanded criteria versus standard criteria donors.

Results
Expanded criteria donors were significantly older than standard criteria donors (P &lt; .001), had higher body mass index (P = .006), and had more frequent arterial hypertension (P &lt; .001) and diabetes mellitus (P = .004) in their histories. When we considered the estimated glomerular filtration rate, graft function in the first 6 months after transplant was significantly worse in kidneys from expanded criteria donors (P = .011). In addition, recipients of grafts from expanded criteria donors had significantly worse survival in the first year posttransplant (P = .023); however, no differences in graft survival were observed.

Conclusion
From the long-term aspect, graft function and graft and patient survival in cases of kidneys from expanded criteria donors were comparable to results with kidneys from standard criteria donors. Expanded use of organs available for transplant is important due to the constantly increasing demands versus limited offers of organs.
P1706THE GRAFT SURVIVAL OF KIDNEY TRANSPLANTATION ACCORDING TO ETHNICITY IN KIDNEY TRANSPLANT RECIPIENTS
Authors: Jung Yeonsoon , Kim Jisu , Jeon Haesu , Kim Ye Na , Shin Ho Sik , Rim Hark 
Published: June 2020

Abstract

Background
African American kidney transplant recipients experience disproportionately high rates of graft loss. The aim of this analysis was to use a UNOS data set that contains detailed baseline and longitudinal clinical data to establish and quantify the impact of the current overall graft loss definition on suppressing the true disparity magnitude in US AA kidney transplant outcomes.

Methods
Longitudinal cohort study of kidney transplant recipients using a data set created by United Network for Organ Sharing (UNOS), including 266,128 (African American 70,215, Non-African American 195,913) transplant patient between 1987 and December 2016. Multivariable analysis was conducted using 2-stage joint modeling of random and fixed effects of longitudinal data (linear mixed model) with time to event outcomes (Cox regression).

Results
195,913 non-African American (AA) (73.6%) were compared with 70,215 AA (26.4%) recipients. 10-year-graft survival of AA in all era is lower than that of non-AA (31% in deceased kidney transplants (DKT) AA recipient and 42% in living kidney transplantation (LKT) non-AA recipient). 10-year-patient survival of AA with functioning graft in all era is similar that of non-AA. Multivariate Cox regression of factors associated with patient survival with functioning graft are acute rejection within 6 months, DM, hypertension and etc. Pre-transplant recipient BMI in AA show the trend as a protective factor in patient survival with functioning graft although not significantly in statistics

Conclusions
African American kidney transplant recipients experience a substantial disparity in graft loss, but not patient death with functioning graft.
P1708EFFECT OF PREGNANCY ON KIDNEY TRANSPLANT RECIPIENTS: A PROPENSITY SCORE-MATCHED STUDY
Authors: Abe Toyofumi , Ayumu Taniguchi , Masataka Kawamura , Taigo Kato , Namba-Hamano Tomoko , Ryoichi Imamura , Norio Nonomura 
Published: June 2020

Abstract

Background and Aims
This study aimed to evaluate whether the experience of pregnancy and delivery would be associated with poor maternal outcome among kidney transplant recipients.

Method
A total of 401 female transplant recipients from the Osaka University Transplantation Group Database were included in this study. 73 women who underwent renal transplantation between 1970 and 2017 and became pregnant and delivered at Osaka University Kidney Transplant Group Hospitals. Multivariable logistic regression analysis was used to assess the impact of pregnancy and delivery on renal transplant recipient outcome after one-to-one propensity score (PS) matching for 12 variables including serum creatinine at one year post-transplant between the parous group and the nulliparous group. The outcomes were kidney graft survival and patient survival.

Results
In all patients before PS matching, 75 (18.7%) of the 401 patients died and 137 (34.2%) of the 401 patients lost their kidney grafts during the follow-up period. In the multivariate analysis, pregnancy and delivery was not a significant risk factor for death (adjusted HR 0.662 [95%CI, 0.265-1.656], p-value 0.378) and for death-censored graft survival (adjusted HR 1.224 [95%CI, 0.683-2.196], p-value 0.497). In the PS matched population, 14 (17.5%) of the 80 patients died and 31 (38.8%) of the 80 patients lost their grafts. In the multivariate analysis, pregnancy and delivery was not a significant risk factor for death (adjusted HR 0.611 [95%CI, 0.180-2.072], p-value 0.430) and for death-censored graft survival (adjusted HR 1.308 [95%CI, 0.501-3.416], p-value 0.584).

Conclusion
Pregnancy and delivery after kidney transplantation was not associated with poor kidney transplant outcome in recipients with adequate and stable graft function.
P1709THE ROLE OF CXCL9 AND CXCL13 IN PREDICTION OF POSTTRANSPLANT INFECTION IN KIDNEY TRANSPLANT RECIPIENTS
Authors: Bai Yangjuan , Yan Lin , Li Yi , Li Yamei , Wang Xianding , Wang Lanlan , Shi Yunying 
Published: June 2020

Abstract

Background and Aims
Chemokines are deeply involved in the process of inflammatory and immune responses. Interferon-γ-inducible chemokines C-X-C motif chemokine 9 and 10 (CXCL9 and CXCL10) are significantly associated with Th1 cells and monocytes and rise rapidly during early episode of renal allograft rejection and various infectious diseases. CXCL13 is one of the most potent B cells and T follicular helper (Tfh) cells chemoattractants when acts through its cognate receptor CXCR5. Recent work of CXCL13 indicated a critical immune regulatory role in both multiple infectious diseases and kidney transplantation. Additionally, C-C motif chemokine 2 (CCL2) is shown to be is critical for chronic kidney diseases. The aim of this study was to identify the predictive role of serum CXCL9, CXCL10, CXCL13 or CCL2 on kidney posttransplant infection.

Method
95 kidney transplant recipients (KTRs) were enrolled in this study. 31 recipients experienced at least once infection episodes within the first posttransplant 12 months and 64 KTRs did not experience any infection episode during the follow-up period. Serum CXCL9, CXCL10, CXCL13 and CCL2 at the time points of pre-transplantation and post-transplant 30 days (POD 30) were analyzed with Bio-Plex® suspension array system.

Results
It was found that serum level of POD 30 CXCL9 and POD 30 CXCL13 was associated with infection within one year after transplantation (P=0.021, P=0.002, respectively, shown in Figure 1). The serum level of CXCL9 and CXCL13 before surgery, the serum level of CCL2 and CXCL10 before and after surgery were not associated with infection within posttransplant one year (P&gt;0.05, shown in Figure 1). The combination of POD 30 CXCL9 plus POD 30 CXCL13 provided the best results with AUC of 0.721 (95%CI, 0.591-0.852), sensitivity of 71.4% and specificity of 68.5% at the optimal cut-off value of 52.72 pg/ml (shown in Figure 2).

Conclusion
Chemokines CXCL9 and CXCL13 as important chemokines could be used to predict the occurrence of infection within posttransplant one year in kidney transplant recipients.
P1710MULTI-NATIONAL SURVEY AMONG NEPHROLOGISTS AND TRANSPLANT SURGEONS ABOUT THE SUITABILITY AND ACCEPTANCE OF MARGINAL LIVE KIDNEY DONORS WITH SICKLE CELL TRAIT
Authors: Arabi Ziad , Mateen Atif , Altheaby Abdulrahman , Hamad Abdullah , Saleh Kaysi , El Hassan El Waleed 
Published: June 2020

Abstract

Background and Aims
Due to organ shortage, many transplant centers may consider “marginal” kidney donors as those with sickle cell trait (SCT) for donation. Acceptance of kidney donors with SCT is in the grey zone, where there are no clear guidelines or consensus toward them. To form a consensus, we conducted a short survey about the suitability and acceptance of living kidney donors with SCT.

Method
This is a cross-sectional survey of nephrologists and transplant surgeons about Suitability and Acceptance of The Marginal Live Kidney Donors. The survey was sent to nephrologists in different countries and it was also distributed through AST& ERA-EDTA.

Results
Of a total of (n=122) respondents from 22 countries: 80.17% (N= 96) were nephrologists and 19.83% (N=23) were transplant surgeons. N= 88 of the respondents (72%) have more than 6 years in practice and they are heavily involved in pre- transplant evaluations of donors and recipients (68.5% of respondents perform donors’ evaluation on weekly or monthly basis and 60 % perform recipient evaluation on weekly basis). The majority (45%) of the respondents were from USA. The completion rate of the survey was 99%. The presence of sickle cell trait was not considered as a contraindication to donor nephrectomy by the majority of respondents (57.38%). Of those (N= 34) 27.87 % of respondents consider them fit for donor nephrectomy after explanation of the risks involved while (N= 36) 29.51 consider them for donor nephrectomy only if there is no other suitable donor available. Out of the total respondents (N= 52) 42.62% considered the presence of sickle cell trait a contraindication to donor nephrectomy.

Conclusion
With lack of consensus and guidelines we found that a significant pool of the transplant physicians and surgeons will consider donors with sickle cell trait for kidney donation especially if there is no other acceptable donor.
P1713A CASE OF DEVASTATING BARIATRIC SURGERY-RELATED ACUTE OXALATE NEPHROPATHY FIRST DIAGNOSED AFTER KIDNEY TRANSPLANTATION
Authors: Santarsia Francesca , Gandolfini Ilaria , Delsante Marco , Palmisano Alessandra , Peyronel Francesco , Sabatino Alice , Regolisti Giuseppe , Fiaccadori Enrico , Maggiore Umberto 
Published: June 2020

Abstract

Background and Aims
Despite the obvious efficacy in achieving weight loss, traditional malabsorptive procedures (intestinal by-pass) used for the treatment of obesity, may be associated with enteric oxaluria. Enteric oxaluria, by causing calcium-oxalate stones and nephrocalcinosis, represents an under-recognized cause of end-stage kidney disease in patients with history of intestinal by-pass. Herein, we describe a patient with a long-standing history of intestinal by-pass who developed a devastating acute oxalate nephropathy first diagnosed after kidney transplantation.

Method
A white female aged 50, who started hemodialysis one year earlier because of tubule-interstitial nephritis on a kidney biopsy, and who had history of recurrent kidney stones (calcium oxalate), underwent urgent deceased-donor kidney transplantation because of exhausted vascular access for hemodialysis (tunneled CVC right giugular vein as the last resort). She had received intestinal by-pass surgery 20 yrs earlier, and had a pacemaker implantation in the left sublavian vein for AV block two years earlier. She was highly sensitized because of blood transfusions at the time of surgery.

Results
After transplantation, graft function had immediate recovery, serum creatinine decreasing to 2.0mg/dL (117 mmol/L) on post-operative day (POD) 3. Shortly after, serum creatinine started rising until it reached 4.0mg/dL (354mmol/L) on POD 5. Three graft biopsies (performed on POD 6, 9 and 15 post-transplant) revealed acute oxalate nephropathy (

Figure1-2
large oxalate crystals on fresh unfixed core of kidney tissue analyzed under bright field microscope using polarized light) with no sign of rejection. Serial monitoring of Luminex SAB did not reveal circulating anti-HLA donor specific antibodies. Fundus examination revealed two tiny mono-lateral retinal oxalate deposits, whereas bone biopsy did not reveal oxalate accumulation. Plasma oxalate levels were 43 mmol/L on POD 10 were urinary oxalate excretion was 29mg /day on POD 14.
The patient slowly progressed to end-stage kidney disease 2-month post-transplantation despite daily high flux dialysis since POD 7, fat-free and oxalate-free diet, oral potassium and high dose pyridoxine supplements.

Conclusion
Patients on chronic dialysis with a previous history of bariatric surgery via intestinal by-pass may have oxalate nephropathy caused by enteric oxaluria as unknown primary renal disease. The disease may recur shortly after transplantation despite the adoption of prompt aggressive treatment for oxalate removal.
P1715CORRELATION OF DONATED KIDNEY MASS AND GRAFT FUNCTION IN RECIPIENTS OF LIVING DONOR KIDNEY TRANSPLANTATION
Authors: Silva Filipa , Pestana Nicole , Ribeiro Catarina Isabel , Carneiro Diogo , Madanelo Mariana , Tavares Joana , Pedroso Sofia , Almeida Manuela , Malheiro Jorge , Dias Leonídio , Silva Ramos Miguel , Martins La Salete , Henriques António Castro 
Published: June 2020

Abstract

Background and Aims
Kidney volume has been proven to be a surrogate marker of nephron mass and renal function in living donors. Although many studies correlate the kidney mass with renal donors’ function after donation, few studies have compared the donated kidney mass with estimated glomerular filtration rate (eGFR) in the kidneýs recipients.
The purpose of this study is to examine the relationship between donor kidney volume and post-transplantation graft function by using computerized tomography to obtain renal volumes.

Method
Clinical data off all donor and recipient pairs undergoing live donor kidney transplantation (KT) at our institution between January 2008 and December 2017 (n=195) were reviewed. The volume of the kidney selected for transplant was determined using volume calculating software and correlate to transplant recipient eGFR.

Results
All metrics of donor kidney volume (DKV): DKV alone, ADK adjusted for weight, body mass index (BMI) or body surface area (BSA), correlated significantly with eGFR (all with p&lt;0,001) at 1 year after KT, with DKV/BSA having the highest correlation (r=0,431). Hence, recipients were divided into terciles according their DKV/BSA (cm3/m2): tercile 1 (DKV/BSA between 49,7-77,5, n=64), tercile 2 (78-95,2, n=63) and tercile 3 (95,4-176, n=63). eGFR differences between groups at each time point were all significant (P&lt;0.05), except for the comparison between T1 and T2 at month 6 (figure 1)
Significant risk factors for eGFR&lt;60 ml/min at 1-year were: acute rejection (AR) at 1-year (OR=4.116, P=0.018); calculated PRA&gt;0% (OR=2.075, P=0.039); higher donor age (OR per unit=1.033, P=0.047); and peritoneal dialysis modality (in comparison with preemptive KT: OR=3.232, P=0.013). Higher (T3) DKV/BSA tercile (in comparison with T1: OR=0.306, P=0.004) was protective of this outcome.
Patients that experienced AR at 1-year had significantly lower DKV/BSA, particularly those with acute cellular rejection (ACR).
The median follow-up was 4,8 years (IQR: 3.2-7.5). The censored graft survival by DKV/BSA terciles at 10 years were 59,3% for group 1, 91.3% for group 2 and 91.1% for group 3 (figure 3).

Conclusion
Our study demonstrates that transplantation of donor-recipient pairs with lower DKV/BSA ratio were associated with significantly worse graft function and higher incidence of AR. This data suggests that a larger mass of nephrons remaining adjusted to recipient’s weight seems to predict a better long-term eGFR. This method can be useful in order to identify patients at risk for a low eGFR after KT and, in cases of multiple potential donors, optimize donor selection.
P1717OUTCOMES OF INCREASED INTRA-ABDOMINAL PRESSURE AFTER KIDNEY TRANSPLANTATION
Authors: Coca Armando , Arias-Cabrales Carlos , Pérez-Sáez Maria José , Gonzalez Pablo , Acosta-Ochoa Isabel , Bustamante-Munguira Elena , Rollan Maria Jesus , Mendiluce Alicia , Pascual Julio , Bustamante-Munguira Juan 
Published: June 2020

Abstract

Background and Aims
Increased intra-abdominal pressure (IAP) is commonly found among post-surgical patients and can induce organ dysfunction. However, its prevalence and impact after kidney transplantation have not been adequately described. We aimed to study the prevalence of increased IAP after kidney transplantation and its consequences on transplant outcomes.

Method
IAP was prospectively measured in 121 kidney transplant recipients every 8h during the first 72h after surgery using the urinary bladder technique (UnoMeter Abdo-Pressure kit). Mean IAP values during the first 24h (24h-IAP) were used in this analysis. Grading of intra-abdominal hypertension was defined according to WSACS guidelines. Patients were followed for at least 12 months or until graft failure or death. The study was approved by the local ethics committee and informed consent was obtained in all cases.

Results
24h-IAP was 12.6±3.5 mmHg. 84.2% of subjects presented with intra-abdominal hypertension during the first 72h after kidney transplantation. Body mass index (OR: 1.35, 95% CI 1.12-1.63; P=0.002), male sex (OR: 3.34, 95% CI 1.1-10.3; P=0.032) and hemodialysis as renal replacement therapy before transplantation (OR: 4.35, 95% CI 1.32-14.4; P=0.016) were independent determinants of intra-abdominal hypertension. IAP was an independent risk factor for delayed graft function (*model adjusted for recipient age, sex, history of previous kidney transplants, recipient comorbidities, donor terminal serum creatinine and comorbidities, number of HLA mismatches &gt;4, cold ischemia time and donation after cardiac death status), graft failure and death (**model adjusted for all variables included in the previous model plus delayed graft failure) (Figure).

Conclusion
Increased IAP was highly common after transplant surgery and was associated with higher rates of delayed graft function, graft failure and death. Routine IAP monitoring should be considered after transplantation to facilitate early identification of complications and initiation of the appropriate treatment to stop its effects.
P1731ABO INCOMPATIBLE DONOR KIDNEY TRANSPLANTATION IN PORTUGAL
Authors: Silva Natalia , Ribeiro Catarina Isabel , Malheiro Jorge , Almeida Manuela , Pedroso Sofia , Martins La Salete , Dias Leonídio , Henriques António Castro , Cabrita António 
Published: June 2020

Abstract

Background and Aims
ABO incompatiblitity was considered a barrier to kidney transplant. However, the shortage of available organs for transplantation and the excellent long term results further establish ABO-incompatible (ABOi) as a safe and effective therapeutic strategy.
The aim of the present study was to evaluate the outcomes of ABOi transplantation in terms of graft survival and function, rejection episodes and infections complications.

Method
The authors present a single center retrospective observational study, that include the analyse of 12 patients who underwent ABOi kidney transplantation between November 2014 and July 2019. All patients received Rituximab (375mg/m2) pre-operation and started Tacrolimus, Mycophenolate Mofetil and Prednisolone one week before surgery. Plasmapheresis was done to remove anti-A or B antibodies until their titles were &lt;1:8 during the first post-operative week and &lt;1:16 at the second.

Results
: A total of 12 patients were included in the study, 75,0% male with 43 years (IQR 31-50) The most common blood group mismatch was A to O (n=4; 33%). In the first year, 2 of patients (17%) developed acute rejection. The follow-up time was 17 months (IQR 7-36). Five patients (42%) developed infectious complications. None patients developed cytomegalovirus or BK polyomavirus infections. At the end graft and patient survival were 100%.

Conclusion
ABOi kidney transplantation has become a routine procedure. By this approach, about 30% of living donors who were refused in the past can now donate their kidneys and thereby significantly expand the living donor pool. Immunosuppressive protocol of this Center can be considered safe.